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. 2017 Dec;101(Suppl 2):121-127.
doi: 10.1007/s12306-017-0481-0. Epub 2017 Jul 31.

Retroverted glenoid reconstruction using glenoid plate in reverse shoulder arthroplasty

R Lanzone  1 , S Carbone  2 , P Albino  3 , J-B Cassio  4 , P Métais  4
Affiliations

Retroverted glenoid reconstruction using glenoid plate in reverse shoulder arthroplasty

R Lanzone et al. Musculoskelet Surg. 2017 Dec.

Abstract

Purpose: The objective of this study is to evaluate the clinical and radiological results of reverse shoulder arthroplasty (RSA) with glenoid plating in a consecutive series of patients affected by cuff tear glenohumeral arthropathy with glenoid retroversion >15°. We hypothesized that autologous humeral head graft may be better stabilized between the baseplate and the native glenoid surface with the use of a glenoid plate.

Methods: Twenty consecutive patients affected by cuff tear arthropathy with glenoid retroversion >15° (B2 or C according to Walch classification) were enrolled in this study. To reconstruct the glenoid, a dedicated plate was used in addition to the standard reverse shoulder baseplate and the glenosphere. Clinical and radiological assessment was performed using constant score (CS), subjective shoulder value (SSV), X-rays and CT scan at 6, 12 and 24 months of follow-up. Healing and resorption of the graft and detection of the glenoid version were assessed.

Results: Sixteen patients were available for final follow-up. The mean preoperative retroversion of the glenoid was 24°, while the post-op was 2° (p = 0.002). At 24 months of follow-up, mean CS and SSV were 61 and 70. Respect to preoperative scores, the results were statistically significant (p < 0.001). The last CT scan revealed: a complete healing of the graft in 100% of cases; graft resorption less than 25% in two patients (12.5%); glenoid retroversion of 4°. A negative statistically significant correlation was found between final CS and preoperative glenoid retroversion (0.039).

Conclusions: The present study reports the favorable outcomes of retroverted glenoid reconstruction with glenoid plates in RSA, an alternative method to address severe glenoid deficiency.

Level of evidence: Level IV, case series with no comparison group.

Keywords: Glenoid bone loss; Glenoid deficiency; Glenoid reconstruction; Retroverted glenoid; Reverse shoulder arthroplasty.

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