Work

Clinical and radiological outcomes of reverse shoulder arthroplasty without preoperative 3D digital planning: a single-surgeon retrospective cohort study

Year: 2026

Type: article

Abstract: This study aimed to evaluate whether reverse shoulder arthroplasty (RSA) can achieve reliable clinical and radiological outcomes when performed using standard instrumentation without preoperative 3-dimensional (3D) digital planning in patients with relatively normal anatomy. We conducted a retrospective cohort study of 103 patients (107 shoulders) who underwent RSA by a single surgeon between 2016 and 2024 without preoperative 3D-CT planning. Clinical endpoints included range of motion (ROM) and patient-reported outcome measures (PROMs): Visual Analog Scale (VAS), Constant score (CS), Subjective Shoulder Value (SSV), and American Shoulder and Elbow Surgeons (ASES) score. Radiological evaluations assessed glenoid inclination and version via X-ray and MRI. At a mean follow-up of 15.4 months, all clinical parameters significantly improved (all P < 0.001). Active forward elevation increased from 67.3° to 127.3°. Significant improvements were seen in CS (30.1 ± 7.2 to 74.2 ± 7.8), SSV (20.9 ± 10.1 to 78.3 ± 9.2), and ASES (33.1 ± 8 to 74.6 ± 8.5), with mean changes exceeding the calculated MCIDs (ASES: 12.23, Constant: 5.62). Radiologically, mean glenoid inclination significantly decreased from 27.9° to 7.2° ( P = 0.006), while retroversion changed from − 3.2° to − 6.5° ( P < 0.001). The overall complication rate was acceptable (6.5%), and most cases were managed conservatively. RSA yields highly predictable, clinically meaningful improvements and adequate radiological correction without advanced 3D planning systems. While digital planning remains valuable, meticulous intraoperative landmark identification and standard surgical techniques achieve excellent, safe outcomes in patients with preserved glenoid morphology.

Source: Journal of Orthopaedic Surgery and Research

DOI: 10.1186/s13018-026-07281-6