Baseplate Options for Reverse Total Shoulder Arthroplasty

Abstract

Purpose of review: Baseplate fixation has been known to be the weak link in reverse total shoulder arthroplasty (RTSA). A wide variety of different baseplates options are currently available. This review investigates the recent literature to present the reader with an overview of the currently available baseplate options and modes of fixation.

Recent findings: The main elements that differentiate baseplates are the central fixation element, the size of the baseplate, the shape, the backside geometry, whether or not an offset central fixation exists, the number of peripheral screws, and the availability of peripheral augmentation. The wide array of baseplate options indicates that no particular design has proven superiority. As such, surgeons should be aware of their options and choose an implant that the surgeon is comfortable with and one that best suits the individual patient anatomy. With the growing number of RTSA procedures and registries with long-term follow-up, future investigations will hopefully delineate the ideal baseplate design to optimize survivorship.

Keywords: Baseplate; Glenoid implant; Metaglene; Shoulder arthroplasty; Shoulder implant; Shoulder replacement.

Fig. 1

Baseplates with different central fixation elements. a Tornier Aequalis Reform Reversed central screw baseplate (Wright Medical Group N.V., Memphis, TN). b Tornier Aequalis Reversed II baseplate with long post (Wright Medical Group N.V., Memphis, TN). c DJO RSP 26-mm monoblock baseplate screw (DJO Surgical, Austin, TX). d Mathys Affinis Inverse Metaglene with two pegs (Mathys Ltd. Bettlach, Switzerland)

Fig. 2

Round, ovoid and pear-shaped baseplates. a Zimmer Biomet Comprehensive Shoulder System mini baseplate (Zimmer Biomet, Warsaw, IN). b Exactech Equinoxe Reverse Shoulder System ovoid baseplate (Exactech Inc., Gainesville, FL). c Exactech Equinoxe Small Reverse Shoulder pear-shaped baseplate (Exactech Inc., Gainesville, FL)

Fig. 3

Flat-back versus curved-back baseplates. a Tornier Aequalis Reform Reversed flat-back baseplate (Wright Medical Group N.V., Menphis, TN). b Lima SMR metal back glenoid curved baseplate (Lima-LTO, Italy)

Fig. 4

Exactech Equinoxe Reverse Shoulder System ovoid baseplate (Exactech Inc., Gainesville, FL)

Fig. 5

Two, four, and six peripheral screw baseplates. a Zimmer Biomet Trabecular Metal Reverse Shoulder System two-screw baseplate (Zimmer Biomet, Warsaw, IN). b Tornier Aequalis Reversed II baseplate with long post (Wright Medical Group N.V., Memphis, TN). c Exactech Equinoxe Reverse Shoulder System ovoid baseplate (Exactech Inc., Gainesville, FL)

Fig. 6

Different designs of available augmented baseplates. a Zimmer Biomet Comprehensive Shoulder System small, medium, and large half-wedge baseplates (Zimmer Biomet, Warsaw, IN). b Tornier Aequalis Perform+ Reversed half-wedge augmented and full-wedge-augmented baseplates (Wright Medical Group N.V., Memphis, TN). c Exactech Equinoxe Reverse System 8° Posterior Augment, 10° Superior Augment, and 10° Superior/8° Posterior Augment Baseplates (Exactech Inc., Gainesville, FL)

Fig. 7

Tornier BIO-RSA and Angled BIO-RSA. a Tornier BIO-RSA System with bone wedge between the baseplate and the glenoid surface. b Tornier BIO-RSA System with an angled bone wedge between the baseplate and the glenoid surface. c Angled BIO-RSA bone wedge mounted on the Tornier baseplate post (Wright Medical Group N.V., Memphis, TN)

Fig. 8

Vault Reconstruction System (VRS). a VRS implant with a mounted glenosphere. b Medial aspect of a VRS implant mounted on a central pin guide. c Posterior aspect of a VRS implant mounted on a central pin guide (Zimmer Biomet, Warsaw, IN)