Minimum two-year follow-up of a reverse total shoulder arthroplasty using a wedged baseplate
Year: 2024
Type: article
Abstract: Background Avoiding inclination of the glenoid baseplate in reverse shoulder arthroplasty often requires considerable glenoid reaming. It is proposed that the use of a metal wedged baseplate in all patients can achieve neutral inclination with reduced glenoid reaming. Materials and Methods A prospective clinical single-centre study with minimum two-year follow-up was carried out. Glenoid deformity was classified on CT and surgery planned using BluePrint TM . The Tornier Perform ® Reversed Wedged Augmented Glenoid was used in all cases. Clinical outcome scores and radiographs were assessed. Results Seventy-three patients, mean age 76.6 years. Twenty-eight demonstrated no glenoid deformity and 19 demonstrated marked retroversion. Seventy completed two-year follow-up. Mean pain scores fell from 6 to 0.7. All Patient Reported Outcome Meaures (PROMS) were significantly improved. Active elevation increased by 62° and external rotation by 28.7° ( p < 0.001). In patients with no glenoid wear (E0/A1), correction of inferior inclination was achievable with a 15° full-wedge baseplate in all cases, reducing the reaming depth by 4.4 mm ( p < 0.001). In patients with severe glenoid wear, a 35° half wedge baseplate was often necessary to correct the deformity. The most common complications were stress reactions/fractures. Conclusion A metal wedged baseplate can achieve neutral inclination in all patients, minimising bone reaming and preserving lateralisation with good two-year outcomes. Level of evidence IV (case series with no comparison group).
Source: Shoulder & Elbow
Institutions: Monash Health, Monash University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funder: Stryker
OpenAlex ID: W4404596146