Onlay versus inlay reverse total shoulder arthroplasty: a retrospective comparison of radiographic and clinical outcomes

Polisetty, Teja S.; Baessler, Aaron; Levy, Jonathan C.; Badman, Brian L.

doi:10.1053/j.sart.2020.11.013

Cited by 19 publications

(31 citation statements)

References 51 publications

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“…Forward flexion (FF) was reported in four studies (Figure 2). 5,9,12,14 The onlay humeral component prosthesis (155 shoulders) showed improved discrete postoperative results (142.36° ± 15.13) versus the inlay humeral component prosthesis (151 shoulders; 135.71° ± 18.59), which was not statistically significant. (Mean difference, 6.65°; p = 0.18).…”

Section: Resultsmentioning

confidence: 91%

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Onlay versus inlay humeral components in reverse shoulder arthroplasty: A systematic review and meta-analysis

et al. 2021

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Background Advances have been made to the traditional inlay Grammont Reverse Shoulder Arthroplasty (RSA) design such as the onlay humeral component prosthesis. Currently, there is no agreement in the literature regarding the best option for the humeral component when comparing inlay and onlay designs. This review compares the outcomes and complications between onlay versus inlay humeral components for RSA. Methods A literature search was conducted using PubMed and Embase. Only studies reporting outcomes comparing onlay versus inlay RSA humeral components were included. Results Four studies with 298 patients (306 shoulders) were included. Onlay humeral components were associated with better external rotation (ER) ( p < 0.0001). No significant difference in forward flexion (FF) or abduction was found. Constant scores (CS) and VAS scores did not differ. Increased scapular notching was found in the inlay group (23.18%) versus the onlay group (7.74%) ( p = 0.02). Postoperative scapular fractures and acromial fractures did not differ. Conclusion Onlay and inlay RSA designs are associated with improved postoperative range of motion (ROM). Onlay humeral designs may be associated with greater ER and lower rate of scapular notching; however, no difference was found in Constant and VAS scores, so further studies are required to assess the clinical significance of these differences.

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Section: Resultsmentioning

confidence: 91%

“…Four papers 5,9,12,14 with a total of 298 patients (306 shoulders) met our search criteria. Of the 306 shoulders, 155 received an onlay humeral component and 151 an inlay humeral component, with a mean patient age of 74.5 ± 5.9 years (125 males, 181 females).…”

Section: Resultsmentioning

confidence: 99%

Onlay versus inlay humeral components in reverse shoulder arthroplasty: A systematic review and meta-analysis

et al. 2021

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“…Heterotrophic ossification was reported in three papers [ 27 , 30 - 31 ] with a total of 35 cases in the lateralised group and 54 cases in the medialised group [ 27 , 30 - 31 ]. Poisetty et al [ 28 ] reported bone resorption in both groups; greater tuberosity (GT) and calcar resorption occurred in 34 and 18 patients, respectively, for the lateralised group, with the medialised group having 13 for GT and only one for calcar.…”

Section: Reviewmentioning

confidence: 99%

“…Acromial fractures were the most commonly reported fractures, the largest number reported by Poisetty et al [ 28 ] with six acromial fractures in the lateralised group and four in the medialised group. There was one additional medialised acromial fracture reported by Nelson et al [ 27 ].…”

Section: Reviewmentioning

confidence: 99%

Reverse Shoulder Arthroplasty Humeral Lateralisation: A Systematic Review

Dhillon¹,

Warren²,

Assiotis³

et al. 2021

Cureus

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“…It can be promoted by using an additional metal or bone stock on the glenoid side [4], or by using a neck-shaft angle of 135 • or 145 • as well as a curved or onlay stem on the humeral side [7]. Comparative clinical studies between lateralized and medialized humeral components have been previously reported [8]. However, there are no published studies in the literature that have specifically analyzed the clinical results of primary RSA using a medialized or lateralized humeral component in patients with a nonfunctional posterior rotator cuff.…”

Section: Introductionmentioning

confidence: 99%

Can Lateralization of Reverse Shoulder Arthroplasty Improve Active External Rotation in Patients with Preoperative Fatty Infiltration of the Infraspinatus and Teres Minor?

Nabergoj

Onishi

Lädermann

et al. 2021

JCM

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(1) Background: Postoperative recovery of external rotation after reverse shoulder arthroplasty (RSA) has been reported despite nonfunctional external rotator muscles. Thus, this study aimed to clinically determine the ideal prosthetic design allowing external rotation recovery in such a cohort. (2) Methods: A monocentric comparative study was retrospectively performed on patients who had primary RSA between June 2013 and February 2018 with a significant preoperative fatty infiltration of the infraspinatus and teres minor. Two groups were formed with patients with a lateral humerus/lateral glenoid 145° onlay RSA—the onlay group (OG), and a medial humerus/lateral glenoid 155° inlay RSA—the inlay group (IG). Patients were matched 1:1 by age, gender, indication, preoperative range of motion (ROM), and Constant score. The ROM and Constant scores were assessed preoperatively and at a minimum follow-up of two years. (3) Results: Forty-seven patients have been included (23 in OG and 24 in IG). Postoperative external rotation increased significantly in the OG only (p = 0.049), and its postoperative value was significantly greater than that of the IG by 11.1° (p = 0.028). (4) Conclusion: The use of a lateralized humeral stem with a low neck-shaft angle resulted in significantly improved external rotation compared to a medialized humeral 155° stem, even in cases of severe fatty infiltration of the infraspinatus and teres minor. Humeral lateralization and a low neck-shaft angle should be favored when planning an RSA in a patient without a functional posterior rotator cuff.

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Onlay versus inlay reverse total shoulder arthroplasty: a retrospective comparison of radiographic and clinical outcomes

Cited by 19 publications

References 51 publications

Onlay versus inlay humeral components in reverse shoulder arthroplasty: A systematic review and meta-analysis

Onlay versus inlay humeral components in reverse shoulder arthroplasty: A systematic review and meta-analysis

Reverse Shoulder Arthroplasty Humeral Lateralisation: A Systematic Review

Can Lateralization of Reverse Shoulder Arthroplasty Improve Active External Rotation in Patients with Preoperative Fatty Infiltration of the Infraspinatus and Teres Minor?

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