Mid-term results of a metal-backed glenoid component in total shoulder replacement

Castagna, Alessandro; Randelli, M; Garofalo, Raffaele; Maradei, L.; Giardella, A.; Borroni, Mario

doi:10.1302/0301-620x.92b10.23578

Cited by 78 publications

(50 citation statements)

References 47 publications

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“…It has been advocated in the litterature [6,7] that with increased lateralisation, the final active elevation would be decreased. This was not confirmed in our study, in which active elevation was comparable with the DELTA-type RSA.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors chose metallic lateralisation of the COR, which keeps the humeral bearing away from the pillar of the scapula. Several implants were designed according to this concept: the RSP (DJO Surgical, Austin, TX, USA) [16], the SMR (Lima, Udine, Italy) [5][6][7] and the Arrow RSA (FH Orthopedics, Mulhouse, France) [28,42]. In the latter, the design of the glenosphere and metal baseplate allows COR lateralisation of 8.5 mm.…”

Section: Introductionmentioning

confidence: 99%

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Does lateralisation of the centre of rotation in reverse shoulder arthroplasty avoid scapular notching? Clinical and radiological review of one hundred and forty cases with forty five months of follow-up

Katz¹,

Valenti²,

Kany³

et al. 2015

International Orthopaedics (SICOT)

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Purpose Our purpose was to evaluate the influence of metallic lateralisation of the centre of rotation (COR) in reverse shoulder arthroplasty (RSA) on the incidence of scapular notching and its eventual clinical and radiological consequences. Methods We analysed 140 RSAs with a lateralised design (Arrow, FH Orthopedics, Mulhouse, France) implanted for massive rotator cuff tear with/without arthritis. Mean followup was 45 months (range 24-120, standard deviation 20). Patients were evaluated clinically using the Constant and Murley (Clin Orthop Relat Res 214:160-164, 1987) score and active range of motion (ROM) and radiologically using standard anteroposterior and axillary view. Scapular notching was assessed according to Sirveaux classification Simovitch et al. (J Bone Joint Surg Am, 89:588-600, 2007), and patients were separated into two groups (scapular notch/no scapular notch) and compared. Results Forty-one notches (29 %) were found: 20 grade 1, 18 grade 2, and three grade 3. The latter three patients had a follow-up of 44, 70 and 84 months, respectively, and the scapular notch did not evolve in the final two years. Better preoperative function was significantly associated with scapular notching (p<0,05 for flexion and abduction), but no final clinical differences in ROM and Constant score were found between groups. A body mass index (BMI) <30 increased the risk of scapular notching, which was observed in 43 % of patients with a BMI<30 and 30 % of patients with a BMI> 30 p=0,048). Pre-operative narrowing of the subacromial space increased the risk of scapular notching, but age or gender showed no influence. However, there was a significantly greater number of scapular notches in patients operated on the dominant side (p=0,04). No significant difference in lateral offset was found between groups (p=0,99). Glenoid implantation in an excessively high position (p=0,033) and absence of inferior tilt (p=0,0029) were significantly associated with scapular notching. Conclusions In this series, metallic lateralisation of the COR in RSA did not impair clinical results, with patients achieving good flexion recovery ROM increase in rotations. Metallic lateralisation of the COR in RSA leads to a lower incidence of scapular notching (29 %) compared with previously reported results using other arthroplastic systems with a more medialised COR. However, although scapular notching was not totally eliminated, those that were found did not evolve over time. Several factors increased the incidence of scapular notching: BMI <30, better preoperative ROM, an excessively high glenoid implant and absence of inferior tilt.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does lateralisation of the centre of rotation in reverse shoulder arthroplasty avoid scapular notching? Clinical and radiological review of one hundred and forty cases with forty five months of follow-up

Katz¹,

Valenti²,

Kany³

et al. 2015

International Orthopaedics (SICOT)

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“…They posited that the use of a screw construct, a fully coated bone in-growth surface at the bone interface and a low profile tray were critical factors in their improved survival. Likewise Castagna reported promising results in a series of 35 glenoids stabilized with screws and a large hallow central peg with a bone in-growth surface [44]. They had no patients who needed revision of their glenoid components during their follow up.…”

Section: Clinical Results For Glenoid Replacementmentioning

confidence: 99%

The glenoid in total shoulder arthroplasty

Schrumpf

Maak

Hammoud

et al. 2011

Curr Rev Musculoskelet Med

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Management of glenohumeral arthrosis with a total shoulder prosthesis is becoming increasingly common. However, failure of the glenoid component remains one of the most common causes for failure. Our understanding of this problem has evolved greatly since the first implants were placed in the 1970's. However glenoid failure remains a challenging problem to address and manage. This article reviews the current knowledge regarding the glenoid in total shoulder arthroplasty touching on anatomy, component design, implant fixation, causes of implant failure, management of glenoid failure and alternatives to glenoid replacement.

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“…The results using all-polyethylene components have been better than those using metal-backed components. The results of 35 total shoulder replacements using a new metal-backed glenoid component with a mean follow-up of 75 months concluded that a metal-backed glenoid component was a good option in total shoulder replacement with results no worse than of those using a cemented all-polyethylene prosthesis (135).…”

Section: Total Shoulder Arthroplastymentioning

confidence: 99%

Orthopaedic Research in Italy: State of the Art

Cenni

Scioscia²,

Baldini

2011

Int J Immunopathol Pharmacol

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The most significant results in experimental and clinical orthopaedic research in Italy within the last three years have been primarily in major congenital diseases, bone tumors, regenerative medicine, joint replacements, spine, tendons and ligaments, The data presented in the following discussion is comparable with leading international results, highlighting Italian orthopaedic research excellemce as well as its shortcomings.There has been continued innovation in orthopaedic research over the past years. The advances in basic science, particularly in molecular and cell biology, in material science and in nanotechnology, has provided the tools for bone engineering, bone imaging and innovative methods for diagnosis and treatment of primitive and metastatic bone tumours. At this point, it seems necessary to examine to what extent are the limitations of these new orthopaedic techniques as well as the prevalent topics that should be explored and the position of the Italian orthopedic research on a global stage.

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Mid-term results of a metal-backed glenoid component in total shoulder replacement

Cited by 78 publications

References 47 publications

Does lateralisation of the centre of rotation in reverse shoulder arthroplasty avoid scapular notching? Clinical and radiological review of one hundred and forty cases with forty five months of follow-up

Does lateralisation of the centre of rotation in reverse shoulder arthroplasty avoid scapular notching? Clinical and radiological review of one hundred and forty cases with forty five months of follow-up

The glenoid in total shoulder arthroplasty

Orthopaedic Research in Italy: State of the Art

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