Bony increased-offset–reverse shoulder arthroplasty: 5 to 10 years' follow-up

Boileau, Pascal; Morin-Salvo, Nicolas; Bessière, Charles; Chelli, Mikaël; Gauci, Marc-Olivier; Lemmex, Devin B.

doi:10.1016/j.jse.2020.02.008

Cited by 60 publications

(38 citation statements)

References 56 publications

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“…The results of the current study seem to support this statement, as we found an overall low frequency of scapular notching in only 9% of cases, all of which were grade 1. However, it must be mentioned that Boileau et al [2] published mid-to long-term results, whereas the current investigation presents short-term results only.…”

Section: Discussioncontrasting

confidence: 51%

“…The second option to reduce notching is lateralization on the glenoid side. This can be achieved by an augmented baseplate (with metal or bone), a lateralized glenosphere, or both [2,10].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Boileau et al published their 5-10-yearresults ofthe BIO-RSA concept in a cohort of 143 consecutive patients [2]. All patients received biologic augmentation on the glenoid side with a bone graft from the humeral head in order to lateralize the component and lengthen the scapular neck.…”

Section: Discussionmentioning

confidence: 99%

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Bipolar lateralization in reverse shoulder arthroplasty for avoidance of scapular notching

Raiss¹,

Neumann²

2020

Obere Extremität

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Introduction Reverse shoulder arthroplasty (RSA) has become a well-established treatment option for multiple disorders of the shoulder joint. In recent years, implant designs and configurations have been modified in order to improve function and avoid complications. Lateralization on the glenoid and the humeral side has been described to improve function and decrease radiographic scapular notching. Data on the clinical and radiographic results of bipolar lateralization in RSA are lacking. Methods In 38 cases, RSA was performed using an uncemented humeral short-stem component with a 145° neck–shaft angle in combination with bone lateralization on the glenoid side (Bony Increased-Offset Reversed Shoulder Arthroplasty, BIO-RSA; Wright Medical Inc., Memphis, TN, USA). Mean follow-up was 19 months (range 12–34 months). Patients were followed clinically using the Constant score as well as range of motion for shoulder flexion and external rotation. Radiographs in two different plains were analyzed for implant seating and the occurrence of scapular notching. Results There was a significant increase in all measured clinical parameters. Forward flexion increased from a mean of 75° preoperatively to 151° postoperatively, and mean Constant score increased from 21 to 71 points postoperatively (p < 0.001). Glenoid notching of grade 1 according to Sirveuax was observed in 3 out of 35 cases (9%); no grade 2, 3, or 4 notching was present. Revision surgery was necessary in one case (3%). Conclusion RSA with bipolar lateralization leads to excellent clinical outcomes, low complication rates, and low rates of radiographic scapular notching. Longer follow-up and prospective randomized trials are needed. Level of evidence Level IV.

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Section: Discussioncontrasting

confidence: 51%

“…The second option to reduce notching is lateralization on the glenoid side. This can be achieved by an augmented baseplate (with metal or bone), a lateralized glenosphere, or both [2,10].…”

Section: Discussionmentioning

confidence: 99%

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Bipolar lateralization in reverse shoulder arthroplasty for avoidance of scapular notching

Raiss¹,

Neumann²

2020

Obere Extremität

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“…[ 13 ] believe that optimal implant positioning is a trade-off between this potential complication and deltoid efficacy. Lateralization can help minimize medialization, which causes notching, using either the glenoid or humeral implant, or a glenoid bone graft [ 11 , 14 , 15 ]. For Boileau et al .…”

Section: Introductionmentioning

confidence: 99%

“…Studies report lateralization between 1 mm and 13 mm [ 1 – 13 ]. For Boileau et al ., graft thickness should be 10 mm [ 9 , 11 , 16 ]. However, lateralization does not seem to impact the DMA [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of the coaptation role of the deltoid in reverse shoulder arthroplasty. A preliminary biomechanical study

et al. 2021

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Background Lateralization of the glenoid implant improves functional outcomes in Reverse Shoulder Arthroplasty. Lateralization does not appear to impact the Deltoid’s Moment Arm. Therefore, the stabilizing effect described in the literature would not be the result of an increase this moment arm. A static biomechanical model, derived from Magnetic Resonance Imaging, can be used to assess the coaptation effect of the Middle Deltoid. The objective of this study was to analyze the impact of increasing amounts of glenoid lateralization on the moment arm but also on its coaptation effect. Methods Eight patients (72.6 ± 6.5 years) operated for Reverse Shoulder Arthroplasty were included in the study. Three-dimensional models of each shoulder were created based on imaging taken at 6 months postoperative. A least square sphere representing the prosthetic implant was added to each 3D models. A static biomechanical model was then applied to different planar portions of the Middle Deltoid (from 3D models), first without lateralization and then with simulated lateralization of 6, 9 and 12mm. This static model enables to compute a Coaptation/Elevation Ratio and to measure the Deltoid’s Moment Arm. The inter- and intra-rater agreement of the 3D models was evaluated. Results One patient was excluded due to motion during imaging. The inter- and intra-rater agreement was over 0.99. The ratio increased starting at 6 mm of lateralization (p<0.05), compared to the initial position. The moment arm was not affected by lateralization (p<0.05), except in two slices starting at 9 mm (S1 p<0.05 and S2 p<0.05). Conclusion Our hypothesis that the Middle Deltoid’s coaptation role would be greater with glenosphere lateralization was confirmed. This trend was not found in the moment arm, which showed little sensitivity to lateralization. The stabilizing effect therefore appears to stem from the coaptation role of the Middle Deltoid.

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