Midterm outcomes of bone grafting in glenoid defects treated with reverse shoulder arthroplasty

Clinical results of bony increased-offset reverse shoulder arthroplasty (BIO-RSA) associated with an onlay 145° curved stem in patients with cuff tear arthropathy: a comparative study

“…Bone integration has been documented in all patients undergoing BIO-RSA, with complete incorporation in 90% of cases and partial in 10% of patients. This is in agreement with the data in the literature, 35 although it is still unclear which are the exact parameters and how long it is necessary to establish the definitive incorporation of the graft. 35 Certainly, the use of postoperative CT allows a more accurate assessment of bone integration.…”

“…This is in agreement with the data in the literature, 35 although it is still unclear which are the exact parameters and how long it is necessary to establish the definitive incorporation of the graft. 35 Certainly, the use of postoperative CT allows a more accurate assessment of bone integration. In the literature, currently, we have found only 4 studies that evaluated bone resorption with CT images; rates of incorporation were 98% in the study by Boileau et al,4 100% in the study by Bateman and Donald al, 3 100% in the study of Greiner et al, 21 and 95% in the study by Lopiz et al 35 The main strength of the study is that all the prostheses were implanted by the same surgeon.…”

“…However, in both groups, the notching rate was lower than the rates reported by studies that used a Grammont humeral stem (20%-60%). 1,4,35,49 This result may be due to 2 factors. First, the positioning of the glenoid baseplate on the inferior part of the glenoid and with an inferior tilt decreases the risk of scapular notching, as demonstrated in a biomechanical study.…”

“…However, in the literature, there is no specific evidence to support this hypothesis, and recent studies reported rates of bone incorporation in elderly patients comparable to rates of other series. 5,35 We do not consider graft integration related to age because we considered that radiographic images were not detailed enough for precise evaluation of the bone graft. The second factor relates to the fact that younger patients could benefit more from a lateralizing implant because of greater muscle trophism and higher probability of presenting with residual and partially functional rotator cuff muscles.…”

“…35 Certainly, the use of postoperative CT allows a more accurate assessment of bone integration. In the literature, currently, we have found only 4 studies that evaluated bone resorption with CT images; rates of incorporation were 98% in the study by Boileau et al,4 100% in the study by Bateman and Donald al, 3 100% in the study of Greiner et al, 21 and 95% in the study by Lopiz et al 35 The main strength of the study is that all the prostheses were implanted by the same surgeon. This is the first work to specifically analyze the effect of BIO-RSA in an implant with a lateralized humeral stem.…”