Clinical outcomes of augmented rTSA glenoid baseplates

Gulotta, Lawrence V.; Grey, Sean G.; Wright, Thomas W.; Zuckerman, Joseph D.; Roche, Christopher P.

doi:10.1053/j.sart.2021.05.010

Cited by 5 publications

(4 citation statements)

References 27 publications

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“…Notably, only three of the included studies were comparative. Klein et al 4 compared the results of patients with glenoid deficiency to those without, Jones et al 32 compared bone grafting to augmented prostheses, and Gulotta et al 33 compared augmented prostheses to standard rtsa. the remainder consisted of single groups of patients undergoing a uniform treatment for glenoid bone loss.…”

Section: Resultsmentioning

confidence: 99%

“…ten studies presented clinical examination findings to report preoperative and postoperative rOm measurements (Figures 2 to 5). 4,5,[32][33][34][35][38][39][40]45 metaanalysis of these included studies demonstrated a significant increase in forward flexion at follow-up (mean difference (MD) 58.5° (95% confidence interval (CI) 51.5° to 65.4°); p < 0.001; Figure 2). From subgroup analysis, an improvement was seen in both bone graft and augmented prosthesis groups.…”

Section: Resultsmentioning

confidence: 99%

“…a total of 11 studies used clinician-and patient-reported functional outcome measures using preoperative and postoperative constant and/or ases assessments (Figures 6 and 7). 4,5,[32][33][34][35][37][38][39][40]45 through analysis of 761 rtsas, a significant improvement was seen in ASES assessments (MD 44.7 (95% CI 41.9 to 47.5); p < 0.001; Figure 6). there was a statistically significant subgroup difference, with the augmented baseplate subgroup having a greater improvement (MD 46.7 (95% CI 44.4 to 49.0) vs MD 40.6 (95% CI 36.3 to 45.0); p = 0.020).…”

Section: Resultsmentioning

confidence: 99%

“…Recently, a meta-analysis addressing the difference between bone graft and augmented prosthesis for glenoid deficiency was conducted by Lanham et al 51 Unfortunately, the search strategy failed to identify several studies crucial for their analysis. 4,33,36,38 Gulotta et al, 33 which remains the largest cohort on the topic to date, was missed. A further limitation of this review was that eight of the 19 included studies included a mix of revision and primary arthroplasty cohorts.…”

Section: Discussionmentioning

confidence: 99%

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Management of glenoid bone loss in primary reverse shoulder arthroplasty

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et al. 2022

The Bone & Joint Journal

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Aims Rates of reverse total shoulder arthroplasty (rTSA) continue to grow. Glenoid bone loss and deformity remains a technical challenge to the surgeon and may reduce improvements in patients’ outcomes. However, there is no consensus as to the optimal surgical technique to best reconstruct these patients’ anatomy. This review aims to compare the outcomes of glenoid bone grafting versus augmented glenoid prostheses in the management of glenoid bone loss in primary reverse total shoulder arthroplasty. Methods This systematic review and meta-analysis evaluated study-level data in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. We performed searches of Medline (Ovid), Embase (Ovid), and PubMed from their dates of inception to January 2022. From included studies, we analyzed data for preoperative and postoperative range of motion (ROM), patient-reported functional outcomes, and complication rates. Results A total of 13 studies (919 shoulders) were included in the analysis. The mean age of patients at initial evaluation was 72.2 years (42 to 87), with a mean follow-up time of 40.7 months (24 to 120). Nine studies with 292 rTSAs evaluated the use of bone graft and five studies with 627 rTSAs evaluated the use of augmented glenoid baseplates. One study was analyzed in both groups. Both techniques demonstrated improvement in patient-reported outcome measures and ROM assessment, with augmented prostheses outperforming bone grafting on improvements in the American Shoulder and Elbow Surgeons Score. There was a higher complication rate (8.9% vs 3.5%; p < 0.001) and revision rate among the bone grafting group compared with the patients who were treated with augmented prostheses (2.4% vs 0.6%; p = 0.022). Conclusion This review provides strong evidence that both bone graft and augmented glenoid baseplate techniques to address glenoid bone loss give excellent ROM and functional outcomes in primary rTSA. The use of augmented base plates may confer fewer complications and revisions. Cite this article: Bone Joint J 2022;104-B(12):1334–1342.

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Section: Resultsmentioning

confidence: 99%