Predictors of Scapular Notching in Patients Managed with the Delta III Reverse Total Shoulder Replacement

Simovitch, Ryan W.; Zumstein, Matthias A.; Lohri, Eveline; Helmy, Naeder; Gerber, Christian

doi:10.2106/jbjs.f.00226

Cited by 450 publications

(334 citation statements)

References 9 publications

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“…Inferior scapular notching is a frequent complication associated with reverse shoulder arthroplasty [4,6,8,[11][12][13][14][15][16]. Sirveaux et al [4] found scapular notching in 49 of 77 patients (63.6 %) at a mean follow-up of 44.5 months.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that mild or moderate scapular notching may have few or no clinical implications in the short-or medium-term following implantation. However, the long-term effects are unclear, and thus there is concern over the possibility that severe notching may jeopardise the stability of the glenoid component and affect the functional outcome [6,8]. Several attempts have been made to reduce the incidence of this drawback by changing the position of the metaglene or conceiving new prosthetic designs.…”

Section: Discussionmentioning

confidence: 99%

“…Nyffeler et al [7] demonstrated that an inferior overhang of the glenosphere beyond the glenoid rim results in the greatest adduction, before impingement of humeral prosthesis against inferior scapular neck occurs. Simovitch et al [8] confirmed that the craniocaudal positioning of the glenosphere, and the angular relationship between the glenosphere and the scapular neck, are highly correlated with the quality of the clinical outcome and the incidence or severity of scapular notching. To avoid this drawback, a new glenosphere was introduced in the Systema Multiplana Randelli (SMR) reverse shoulder prosthesis which has an eccentric shape (eccentric glenosphere), making it possible to lower the centre of rotation and theoretically decrease or avoid scapular notching compared with the current concentric glenosphere [7,9].…”

Section: Introductionmentioning

confidence: 96%

See 2 more Smart Citations

The use of an eccentric glenosphere compared with a concentric glenosphere in reverse total shoulder arthroplasty: two-year minimum follow-up results

Biase

Ziveri

Delcogliano

et al. 2013

International Orthopaedics (SICOT)

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Purpose The current models of reverse shoulder arthroplasty (RSA) expose the procedure to the risk of scapular notching, possibly leading to loosening of the glenoid. We compared the clinical and radiographic results obtained with a concentric or eccentric glenosphere to assess whether the eccentric design might give better clinical results and avoid or decrease the risk of scapular notching Methods Of our patients, 31 underwent RSA using a concentric glenosphere (group A), while 29 had an eccentric glenosphere (group B). Postoperatively, patients were followed-up at one to 12 months and annually thereafter, with the mean being 33 months in group A and 27.5 in group B. In both groups the minimum follow up (F-U) was 24 months. Preoperatively and at each F-U starting from six months, patients were assessed using the Constant score. On radiographs, prosthesis scapular neck angle (PSNA), distance between scapular neck and glenosphere (DBSNG) and peg-glenoid rim distance (PGRD) were calculated. The severity of notching was classified in four grades. ResultsIn group A the mean Constant score increased by 30 points compared to the preoperative score and the active ROM increased considerably. At latest F-U, the mean PSNA, DBSNG and PGRD were, respectively, 87°, 3.4 mm and 19.8 mm.Glenoid notching was present in 42 % of cases. In group A, the mean Constant score increased by 34 points and the mean ROM was better than in group A. The average PSNA, PGRD and DBSNG were, respectively, 92°, 21.2 mm and 4.3 mm. Radiographs showed no inferior scapular notching. Conclusions The eccentric glenosphere yielded better clinical results than the concentric glenosphere and was associated with no scapular notching.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

See 1 more Smart Citation

The use of an eccentric glenosphere compared with a concentric glenosphere in reverse total shoulder arthroplasty: two-year minimum follow-up results

Biase

Ziveri

Delcogliano

et al. 2013

International Orthopaedics (SICOT)

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“…It is reported that scapular notching is the most regular complication associated with RSP (39). Also, it is suggested that scapular notching is due to the prosthesis design.…”

Section: Scapular Notchingmentioning

confidence: 99%

A brief Review of Reverse Shoulder Prosthesis: Arthroplasty, Complications, Revisions, and Development

Özada¹,

Yazdi²,

Khandan³

et al. 2017

Trauma Mon

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Human shoulder is considered to be an important flexible and movable part in the human body. However, it is a wobble joint as its range of motion (ROM) is high. This unstable status causes the rate of joint injury. The processes leading to shoulder joint dysfunction are arthritis, hemiarthroplasty failure, and pseudoparalysis; in turn, one of the main factors contributing to these problems is rotator cuff tear (RCT). Reverse shoulder arthroplasty (RSA) may be a proper treatment for shoulder dysfunction and pain. This treatment that elevates shoulder movement has been augmented by recent advances in the development of the reverse shoulder prosthesis (RSP) design. The current review highlights the recent developments, revisions, and complications. The review of the published literature has been done to determine the overall rates of problems, complications, reoperations, and revisions after RSA. Furthermore, this review discusses the problems concerning RSP, shoulder joint replacement, and improvement in shoulder joint movement after arthroplasty. Ultimately, an outcome of different endeavors of the researcher was summarized. The endeavor of the current review indicates that RSA is a valuable alternative that can increase forward elevation, improve function, and relieve pain.

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“…In recent years, RTSA models have gained popularity and seem to currently boast the best functional outcome [18,21,38,39], since this prosthetic design enables a distalisation and medialisation of the prosthetic centre of rotation [10,19,20]. However, notching with consecutive glenoid loosening, instability and infection are still common problems in this prosthetic design [4,15,30,36,40].…”

Section: Introductionmentioning

confidence: 99%

Functional and clinical outcome of total shoulder arthroplasty with oversized glenoid

Jeske

Wambacher

Dallapozza

et al. 2012

Arch Orthop Trauma Surg

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The semi-constraint reconstruction glenoid prosthesis model in cuff-tear-arthropathy patients significantly improves shoulder function, however, it yields controversial results, with satisfactory results in male and poor results in female patients. Revision rate of the female cohort and loosening of the glenoid component in this short-term follow-up is of concern. Further investigations taking BMD, osteopenic conditions and influence of surface area in smaller individuals into consideration are recommended, to determine whether this is the underlying cause of the inferior results in females.

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Predictors of Scapular Notching in Patients Managed with the Delta III Reverse Total Shoulder Replacement

Abstract: Inferior scapular notching after reverse total shoulder arthroplasty adversely affects the intermediate-term clinical outcome. It can be prevented by optimal positioning of the glenoid component.

Cited by 450 publications

References 9 publications

The use of an eccentric glenosphere compared with a concentric glenosphere in reverse total shoulder arthroplasty: two-year minimum follow-up results

The use of an eccentric glenosphere compared with a concentric glenosphere in reverse total shoulder arthroplasty: two-year minimum follow-up results

A brief Review of Reverse Shoulder Prosthesis: Arthroplasty, Complications, Revisions, and Development

Functional and clinical outcome of total shoulder arthroplasty with oversized glenoid

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