A Comparison of Concentric and Eccentric Glenospheres in Reverse Shoulder Arthroplasty

Poon, Peter C.; Chou, Jerry; Young, Simon W.; Astley, T.

doi:10.2106/jbjs.m.00941

Cited by 64 publications

(27 citation statements)

References 34 publications

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“…In the patients, the mean PSNA, PGRD, and inferior overhang were 92°, 21.2 mm, and 4.3 mm, respectively. Poon et al 15) suggested that more than 3.5 mm of inferior overhang could prevent notching; however, there were no differences in the incidence of notching or clinical results between concentric and eccentric glenospheres. In our study, the 5.8 mm eccentric glenosphere with 15° of inferior tilt could reduce the incidence of notching, but grade 1 notching occurred in 2 patients.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Clinical and Radiological Results according to Glenosphere Position in Reverse Total Shoulder Arthroplasty: A Short-term Follow-up Study

et al. 2017

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BackgroundIn a previous biomechanical study, eccentric glenospheres with more inferior position of the center of rotation were shown to improve range of motion and reduce the incidence of scapular notching after reverse total shoulder arthroplasty (RSA). The purpose of this study was to compare the clinical and radiological results of RSA using an eccentric glenosphere to those using a concentric glenosphere and to determine the usefulness of the eccentric glenosphere.MethodsFrom 2009 to 2015, we performed a retrospective review of 20 consecutive patients who underwent RSA using a deltopectoral approach. Nine patients underwent RSA using a concentric glenosphere (group A) while 11 had an eccentric glenosphere (group B). The average follow-up period was 13.9 months (range, 12 to 18 months). All glenoid components were placed with 15° of inferior tilt. Clinical results were assessed using the visual analog pain scale score (VAS), the American Shoulder and Elbow Surgeon (ASES) score, the Korean shoulder scoring system (KSS), and the Constant score. On radiological evaluation, prosthesisscapular neck angle (PSNA), peg-glenoid rim distance (PGRD), scapular neck-inferior glenoshere rim distance (inferior glenoshpere overhang), acromion-greater tuberosity (AT) distance, glenoid-greater tuberosity (GT) distance, and severity of notching according to the Nerot-Sirveaux classification were assessed.ResultsThe clinical results improved significantly in both groups, but there was no statistically significant difference between the two groups. A significant intergroup difference was observed with regard to PGRD (24.8 ± 1.6 mm for group A vs. 22.2 ± 1.9 mm for group B; p = 0.002) and inferior glenosphere overhang (2.0 ± 1.7 mm for group A vs. 5.8 ± 1.6 mm for group B; p = 0.000). Seven of 9 patients in group A developed notching compared with 2 of 11 patients in group B (p = 0.022). The other radiological parameters such as inferior tilt and AT and GT distances were not significantly different between two groups. Complications such as loosening and scapular fractures did not occur.ConclusionsThe eccentric glenosphere in RSA was more effective in reducing the rate of notching than the concentric glenosphere although clinical outcomes were not significantly different in the short-term follow-up.

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Section: Discussionmentioning

confidence: 99%

Comparison of Clinical and Radiological Results according to Glenosphere Position in Reverse Total Shoulder Arthroplasty: A Short-term Follow-up Study

et al. 2017

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“…Roche and colleagues 14 reviewed the radiographs of 151 patients who underwent primary reverse TSA at a mean follow-up of 28.3 months postoperatively; they found that 13.2% of their patients had a notch and that, on average, their patients who had no scapular notch had significantly more inferior glenosphere overhang than those who had a scapular notch. Poon and colleagues 15 found that a glenosphere overhang of >3.5 mm prevented notching in their randomized control trial comparing concentrically and eccentrically placed glenospheres. Multiple other studies have demonstrated similar results and recommended inferior glenoid translation and inferior glenoid inclination to avoid scapular notching.…”

Section: Glenosphere Placementmentioning

confidence: 99%

Patient-Specific Guides/Instrumentation in Shoulder Arthroplasty

Ward

Dines²

2018

Am J Orthop

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Optimal outcomes following total shoulder arthroplasty TSA and reverse shoulder arthroplasty RSA are dependent on proper implant position. Multiple cadaver studies have demonstrated improved accuracy of implant positioning with use of patient-specific guides/instrumentation compared to traditional methods. At this time, there are 3 commercially available single use patient-specific instrumentation systems and 1 commercially available reusable patient-specific instrumentation system. Currently though, there are no studies comparing the clinical outcomes of patient-specific guides to those of traditional methods of glenoid placement, and limited research has been done comparing the accuracy of each system's 3-dimensional planning software. Future work is necessary to elucidate the ideal indications for the use of patient-specific guides and instrumentation, but it is likely, particularly in the setting of advanced glenoid deformity, that these systems will improve a surgeon's ability to put the implant in the best position possible.

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“…With innovations in reverse implant design and improvements in surgical technique, the occurrence of notching has decreased. Poon et al performed a randomized controlled trial comparing the results of concentric and eccentric glenospheres in reverse shoulder arthroplasty 24 . The surgical technique for both groups involved the placement of the glenoid baseplate flush with the inferior glenoid rim.…”

Section: Shoulder Arthroplastymentioning

confidence: 99%

What’s New in Shoulder and Elbow Surgery

Chamberlain

Aleem

Keener

2017

The Journal of Bone and Joint Surgery

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This update is a review of the most impactful studies related to advances in shoulder and elbow surgery from March 2014 to March 2015. Included are basic science and clinical studies primarily from The Journal of Bone & Joint Surgery, the Journal of Shoulder and Elbow Surgery, and The American Journal of Sports Medicine. Specific emphasis has been placed on higherquality research (Level-I and II studies) and particularly relevant Level-III and IV studies. The level of evidence is provided (when known). Shoulder Rotator Cuff Clinical Presentation Specialty Update has been developed in collaboration with the Board of Specialty Societies (BOS) of the American Academy of Orthopaedic Surgeons.

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A Comparison of Concentric and Eccentric Glenospheres in Reverse Shoulder Arthroplasty

Abstract: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Cited by 64 publications

References 34 publications

Comparison of Clinical and Radiological Results according to Glenosphere Position in Reverse Total Shoulder Arthroplasty: A Short-term Follow-up Study

Comparison of Clinical and Radiological Results according to Glenosphere Position in Reverse Total Shoulder Arthroplasty: A Short-term Follow-up Study

Patient-Specific Guides/Instrumentation in Shoulder Arthroplasty

What’s New in Shoulder and Elbow Surgery

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