Glenoid morphology in reverse shoulder arthroplasty: Classification and surgical implications

Frankle, Mark A.; Teramoto, Atsushi; Luo, Zong‐Ping; Levy, Jonathan C.; Pupello, Derek

doi:10.1016/j.jse.2009.02.013

Cited by 198 publications

(140 citation statements)

References 29 publications

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“…Studies examining intraoperative complications, such as periprosthetic fractures [2,11,12,16,20,[22][23][24] during revision reverse shoulder arthroplasty have been done. There is a relatively high frequency of early complications associated with the procedure, partly attributable to the technical demands of the surgery and its relatively recent approval for use (2004) in the United States [2,11,16,20,22,23].…”

Section: Discussionmentioning

confidence: 99%

“…There is a relatively high frequency of early complications associated with the procedure, partly attributable to the technical demands of the surgery and its relatively recent approval for use (2004) in the United States [2,11,16,20,22,23]. Therefore, the purposes of our study were to assess the frequency, risk factors, and early outcomes associated with intraoperative periprosthetic humerus fractures in patients undergoing revision reverse shoulder arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

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What Are Risk Factors for Intraoperative Humerus Fractures During Revision Reverse Shoulder Arthroplasty and Do They Influence Outcomes?

Wagner

Houdek

Elhassan

et al. 2015

Clin Orthop Relat Res

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Background With the increase in shoulder arthroplasty rates, the number of perioperative complications, such as periprosthetic fractures, continues to be a rise; however, the risk factors and incidence of intraoperative complications, such as fractures, during revision reverse shoulder arthroplasty are not well established. Questions/purposes We evaluated patients receiving a reverse shoulder arthroplasty to determine (1) the frequency and characteristics of intraoperative humerus fractures, (2) the risk factors for fracture, (3) the complications associated with treatment of fractures, and (4) clinical and functional outcomes after treatment. Methods Using one institution's total joint registry, we performed a retrospective analysis of medical records of 224 patients (230 shoulders) who underwent revision surgery to reverse shoulder arthroplasty, from 2005 to 2012, for failed total shoulder arthroplasty. Reverse shoulder arthroplasty was used when there was a deficient rotator cuff, prior instability, or deficient glenoid bone stock. Intraoperative periprosthetic humerus fractures occurred in 36 shoulders (16%) (36 patients). The clinical outcome analysis included 29 patients with a minimum 2-year clinical followup (mean followup, 3.1 years; range, 2.0À6.3 years). The control group consisted of 188 patients (194 shoulders), and it was used for risk-factor calculation; whereas only 150 patients (154 shoulders) in the control group had a minimum 2-year followup, and thus only 150 patients (154 shoulders) made up the comparators (controls) for outcome-analysis comparisons. Risk factors were assessed using univariate analysis with odds ratios (OR), whereas implant survival and complications were assessed using the Kaplan-Meier method. Results Three displaced and 33 nondisplaced fractures occurred during revision reverse total shoulder arthroplasties. Most of the fractures (81%) occurred during component removal of cemented (n = 11) and cementless (n = 25) components. Intraoperative fractures only were treated with stabilization of the prosthetic stem in 28 patients, while adjunctive internal fixation was used in eight patients. Risk of intraoperative periprosthetic fractures was increased by factors including female sex (n =18 women; OR, 2.41; range, 1.11À5.68; p = 0.03); history of instability (n = 27; OR, 2.65; range, 1.18À5.93; p = 0.02); and prior hemiarthroplasty (n = 22; OR, 2.34; range, 1.13À4.84; p = 0.03). There were two postoperative fractures in patients who had an intraoperative fracture and both were treated nonoperatively. Overall, three (8%) revision procedures were performed in patients with intraoperative fractures, with 2-and 5-year survivorship estimates of 94% and 85%, respectively, compared with 89% and 84%, respectively for patients without an intraoperative fracture (p = 0.45). At latest followup, patients

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

What Are Risk Factors for Intraoperative Humerus Fractures During Revision Reverse Shoulder Arthroplasty and Do They Influence Outcomes?

Wagner

Houdek

Elhassan

et al. 2015

Clin Orthop Relat Res

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“…12,17,18,25,26 Since the 3-point system requires the entire scapula, we limited this comparison to 40 of our CTs that met with the requirement. We evaluated the difference (mean, range) of orientation between these two definitions of the scapular plane.…”

Section: Methodsmentioning

confidence: 99%

“…A 3D assessment of the glenoid orientation was achieved by measuring the inclination of the glenoid, or the location of maximum erosion. 15,18 Various other alternatives were proposed to define the glenoid surface in 3D, either by fitting a plane 19,20 or a sphere. 21,22 In order to characterise the morphology of eroded glenoid surfaces in 3D, we looked for a set of morphological parameters for TSR planning and evaluated their potential on a series of normal and osteoarthritic shoulders.…”

mentioning

confidence: 99%

Measurements of three-dimensional glenoid erosion when planning the prosthetic replacement of osteoarthritic shoulders

Terrier

Ston

Larrea

et al. 2014

The Bone & Joint Journal

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The three-dimensional (3D) correction of glenoid erosion is critical to the long-term success of total shoulder replacement (TSR). In order to characterise the 3D morphology of eroded glenoid surfaces, we looked for a set of morphological parameters useful for TSR planning. We defined a scapular coordinates system based on non-eroded bony landmarks. The maximum glenoid version was measured and specified in 3D by its orientation angle. Medialisation was considered relative to the spino-glenoid notch. We analysed regular CT scans of 19 normal (N) and 86 osteoarthritic (OA) scapulae. When the maximum version of OA shoulders was higher than 10°, the orientation was not only posterior, but extended in postero-superior (35%), postero-inferior (6%) and anterior sectors (4%). The medialisation of the glenoid was higher in OA than normal shoulders. The orientation angle of maximum version appeared as a critical parameter to specify the glenoid shape in 3D. It will be very useful in planning the best position for the glenoid in TSR. Osteoarthritis (OA) of the gleno-humeral joint is often associated with an erosion of the glenoid.

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“…[10][11][12][13] However, RTSA have been associated with complications such as hematoma, infection, scapular notching, instability, acromial fractures, and component loosening at a high rate. [14][15][16] Especially, scapular notching and loosening of the glenoid baseplate are the most common complications associated with RTSA; the prevalence of scapular notching in RTSA patients has been reported to be 0% to 96%, and that of glenoid baseplate loosening to be 0.4% to 11.2%.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Radiological Results of Reverse Total Shoulder Arthroplasty Using a 25-mm Glenoid Baseplate

Lee¹,

Kim²,

Jung³

2015

Clinics in Shoulder and Elbow

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Background: The size of the baseplate used in reverse total shoulder arthroplasty (RTSA) tends to be larger than the average size of the glenoid in the Korean population. The mismatch between the sizes of the baseplate and the patient's glenoid may result in improper fixation of the glenoid baseplate. This in turn may lead to the premature loosening of the glenoid component. Thus, we evaluated the short-term results of using a 25-mm baseplate in RTSA. Methods: Seventeen patients with cuff tear arthropathy underwent RTSA with a 25-mm baseplate. The mean age of the patients was 70.1 years, and the mean follow-up period was 14.0 months. We evaluated clinical outcomes preoperatively and postoperatively: the range of shoulder motion, the American Shoulder and Elbow Surgeons (ASES) score, and the Korean Shoulder Society (KSS) score. Results: We found that the mean ASES score and KSS improved from 35.0 to 74.4 (p<0.001) and from 46.9 to 71.8 (p<0.001) with RTSA. The mean forward elevation and abduction, external rotation also improved from 78.6° to 134.3° (p<0.05) and from 66.6° to 125.0° (p<0.05), from 20.2° to 28.4° (p=0.43). Postoperative complications were seen in 12% of patients, but neither the loosening of the glenoid baseplate nor inferior scapular notching were observed. Conclusions: In sum, the results of using a 25-mm baseplate in RTSA were similar to those of previous reports. Even though the outcomes are those of a short-term follow-up, neither the loosening of the glenoid baseplate nor the scapular notching were observed. (Clin Shoulder Elbow 2015;18(4):242-247)

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Glenoid morphology in reverse shoulder arthroplasty: Classification and surgical implications

Cited by 198 publications

References 29 publications

What Are Risk Factors for Intraoperative Humerus Fractures During Revision Reverse Shoulder Arthroplasty and Do They Influence Outcomes?

What Are Risk Factors for Intraoperative Humerus Fractures During Revision Reverse Shoulder Arthroplasty and Do They Influence Outcomes?

Measurements of three-dimensional glenoid erosion when planning the prosthetic replacement of osteoarthritic shoulders

Clinical and Radiological Results of Reverse Total Shoulder Arthroplasty Using a 25-mm Glenoid Baseplate

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