Work

Excellent survivorship and improved active shoulder range of motion 5 years post-reverse total shoulder arthroplasty with mini-augmented glenoid baseplate and mini-humeral tray

Year: 2026

Type: article

Abstract: Background Following reverse total shoulder arthroplasty (rTSA) scapular notching and biomechanical impingement can increase pain and decrease function. Mini-augmented glenoid baseplate (AGB) and offset humeral tray use may improve biomechanics, correct glenoid bone deficiency, and decrease complications. This 5-year post-rTSA study is the follow-up to a previous 2-year patient outcome study. The hypothesis was that 5-year patient outcomes would be comparable or better than those observed at 2-years with the lower implant profile group displaying superior active range of motion (ROM) and patient reported outcome measurement (PROM) results. Materials and Methods Ninety-eight patients received one of three different glenoid baseplate and humeral tray combinations: Group 1 (mini-AGB and a 44-mm concentric humeral tray); Group 2 (non-AGB and a 40-mm, mini-humeral tray with 3 offset options); or Group 3 (mini-AGB and 40-mm mini-humeral tray with 3 offset options). Patients underwent radiologic evaluations, completed the American Shoulder and Elbow Society shoulder score (ASES), the EQ-5D-5L quality of life scale, VAS shoulder pain and instability questions, and underwent active shoulder ROM measurements pre-rTSA, and 6-weeks, 6-months, 1-, 2-, 3-, and 5-years post-rTSA. Results Fifty-eight subjects completed 5-year follow-up. More Group 2 subjects had mild glenoid erosion and more Group 1 subjects had moderate glenoid erosion (Chi-Square = 14.6, p=0.006). More Group 3 subjects had subscapularis repair (Chi-Square statistic=6.8, p=0.03). Across the 5-year post-rTSA study period subjects who received the combined mini-AGB and mini-humeral tray with offset option (Group 3) had greater overall active shoulder flexion than Group 1 (p ≤ 0.04), greater active shoulder external rotation (90° abducted) than Group 2 (p ≤ 0.05), and greater active shoulder internal rotation than Groups 1 and 2 (p < 0.001). Effect sizes were small (0.23 – 0.24). Excellent implant survival (98.3%), minimal scapular notching, and comparable PROM were observed in each group. Conclusion Greater active shoulder ROM was observed in subjects that received the lower profile mini-AGB and mini-humeral tray. High implant survival, low scapular notching rates, and PROM improvements were observed for all groups. Level of Evidence Level IV, Retrospective Case Series.

Source: Journal of Shoulder and Elbow Arthroplasty

DOI: 10.1016/j.jsea.2026.100103

Authors: Ryan Krupp, Christopher O'Grady, Brian Werner, J. Michael Wiater, John Nyland, Thomas Duquin