Title

Inferior glenosphere placement reduces scapular notching in reverse total shoulder arthroplasty

Publication Date

2015

Journal Title

Orthopedics

Abstract

Scapular notching is a common complication after reverse shoulder arthroplasty and has been associated with poor clinical outcomes. Factors associated with notching include neck shaft angle and glenosphere position. The goal of this study was to evaluate the incidence of notching with an eccentric glenosphere that allows for inferior offset as well as its effect on clinical outcome. The charts of 82 patients who underwent reverse shoulder arthroplasty with this eccentric glenosphere were retrospectively reviewed. Scapular notching was assessed with standard anteroposterior radiographs of the glenohumeral joint according to the Nerot-Sirveaux classification system. Two experienced observers evaluated all radiographs. The presence of radiolucent lines was also evaluated. Both range of motion (ROM) and Constant-Murley scores were obtained. Average age was 74 years (range, 61-91 years), and follow-up was 26.3 months (range, 19-39 months). According to the Nerot-Sirveaux classification, 73 (89%) had no notching, 5 (6%) had grade I notching, 2 (2.5%) had grade II notching, and 2 (2.5%) had grade III notching. The overall presence of notching was 11% and correlated to the amount of inferior offset. No radiolucent lines were seen around the prosthesis. Both ROM and Constant-Murley scores (from 31.3 to 74.2) improved significantly in all patients from preoperative evaluation to final follow-up (P

Volume Number

38

Issue Number

2

Pages

e88-93

Document Type

Article

EPub Date

2015/02/11

Status

Faculty; Northwell Researcher

Facility

School of Medicine; Northwell Health

Primary Department

Orthopedic Surgery

PMID

25665124

DOI

10.3928/01477447-20150204-54