Journal of shoulder and elbow surgery | 2021
Early Clinical and Radiographic Outcomes of an Augmented Baseplate in Reverse Shoulder Arthroplasty for Glenohumeral Arthritis with Glenoid Deformity.
Abstract
BACKGROUND\nGlenoid deformity is commonly encountered in patients undergoing reverse shoulder arthroplasty (RSA). Augmented baseplates can correct glenoid deformity while potentially avoiding certain complications encountered with structural bone graft. Limited evidence exists to support the use of metallic augmented baseplates in RSA.\n\n\nMETHODS\nA retrospective review was performed for all patients treated with an augmented baseplate during primary RSA with a minimum of 1 year clinical and radiographic follow-up. Preoperative radiographs and advanced imaging were used to determine glenoid morphology and deformity. Postoperative radiographs were used to evaluate for deformity correction, radiographic complications and early baseplate loosening or failure. Prospectively collected clinical data and patient reported outcome scores were determined.\n\n\nRESULTS\n44 patients (mean age, 72 ± 6 years) underwent primary RSA with an augmented baseplate (15 half-wedge, 29 full-wedge). Glenoid retroversion was significantly improved for the entire cohort (P = .001). Among the 22 patients with either Walch B2/B3 or C glenoid morphology, glenoid version improved from 28° ± 8° to 16° ± 8° (P = .001). Glenoid inclination as determined by the β-angle was significantly improved for the entire cohort (P < .001). Among the 18 patients with Favard E2/E3 glenoid morphology, glenoid inclination improved from 67°± 7° to 81°±8° (P < .001). Postoperative range of motion and functional outcome scores including the American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST), Single Assessment Numeric Evaluation (SANE) and visual analog scale (VAS) for pain significantly improved among the entire cohort (P < .05). No patients had evidence of baseplate loosening or failure of the glenoid component. Five (11.4%) patients developed acromial stress fractures and 2 (4.5%) patients underwent a reoperation unrelated to the glenoid component.\n\n\nDISCUSSION/CONCLUSION\nPrimary RSA with an augmented baseplate results in excellent short-term clinical outcomes and significant deformity correction in patients with advanced glenoid deformity. There were no complications related to the augmented baseplate or glenoid component. The rate of acromial stress fractures appears higher than typically reported and warrants further investigation.