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. 2024 Nov 21;17(6):736-747.
doi: 10.1177/17585732241293396. eCollection 2025 Oct.

Minimum two-year follow-up of a reverse total shoulder arthroplasty using a wedged baseplate

Simon J M Parker  1 , Simon N Bell  1   2 , Féoline Wiemer  1   2 , Jennifer A Coghlan  1   2 , Harry D Clitherow  1   2 , Helen M Rayment  1
Affiliations

Minimum two-year follow-up of a reverse total shoulder arthroplasty using a wedged baseplate

Simon J M Parker et al. Shoulder Elbow. .

Abstract

Background: Avoiding inclination of the glenoid baseplate in reverse shoulder arthroplasty often requires considerable glenoid reaming. It is proposed that the use of a metal wedged baseplate in all patients can achieve neutral inclination with reduced glenoid reaming.

Materials and methods: A prospective clinical single-centre study with minimum two-year follow-up was carried out. Glenoid deformity was classified on CT and surgery planned using BluePrintTM. The Tornier Perform® Reversed Wedged Augmented Glenoid was used in all cases. Clinical outcome scores and radiographs were assessed.

Results: Seventy-three patients, mean age 76.6 years. Twenty-eight demonstrated no glenoid deformity and 19 demonstrated marked retroversion. Seventy completed two-year follow-up. Mean pain scores fell from 6 to 0.7. All Patient Reported Outcome Meaures (PROMS) were significantly improved. Active elevation increased by 62° and external rotation by 28.7° (p < 0.001). In patients with no glenoid wear (E0/A1), correction of inferior inclination was achievable with a 15° full-wedge baseplate in all cases, reducing the reaming depth by 4.4 mm (p < 0.001). In patients with severe glenoid wear, a 35° half wedge baseplate was often necessary to correct the deformity. The most common complications were stress reactions/fractures.

Conclusion: A metal wedged baseplate can achieve neutral inclination in all patients, minimising bone reaming and preserving lateralisation with good two-year outcomes.

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

Keywords: augmented; baseplate; glenoid inclination; outcomes; reverse shoulder arthroplasty; wedge.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: SB has a paid consultancy agreement with Stryker and Mathys Inc. HC has a paid consultancy agreement for Mathys Inc.

Figures

Figure 1.
Figure 1.
Manufacturer's photograph of the 15° full-wedge (left) and 35° half-wedge augmented baseplate and glenosphere with central (green) and peripheral (grey) screw position.
Figure 2.
Figure 2.
Classification of glenoid erosion by Favard et al.
Figure 3.
Figure 3.
A modified classification of glenoid morphology by Bercik et al.,17 based on the original of Walch et al.
Figure 4.
Figure 4.
Classification of scapular notching by Sirveaux et al.
Figure 5.
Figure 5.
Humeral zones for assessment of radiolucent lines.
Figure 6.
Figure 6.
The CONSORT flowchart.
Figure 7.
Figure 7.
Case example of BluePrintTM planning software used to compare flat (A) and superior augmented wedge (B) baseplate options, as well as predict inferior glenoid bone loss secondary to reaming, shaded in yellow (C).
See this image and copyright information in PMC

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