[Replacement of the Glenoid Using a Reconstruction Socket (EPOCA RECO]

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering

Background:

• Cuff tear arthropathy often leads to debilitating shoulder pain and functional loss.
• Failed shoulder prostheses (hemiprosthesis or reverse shoulder prosthesis) present a surgical challenge.

Purpose of the Study:

• To evaluate the efficacy of the EPOCA RECO (External Periosteal Osteosynthesis Construct for Articular) reconstruction socket in treating cuff tear arthropathy.
• To assess pain reduction, functional restoration, and range of motion improvement following EPOCA RECO implantation.

Main Methods:

• The study involved 35 EPOCA RECO implantations in 34 patients with cuff tear arthropathy and insufficient coracoacromial arch.
• Surgical technique included a deltopectoral approach, humeral head resection, glenoid exposure, and three-point fixation of the EPOCA RECO socket.
• Postoperative management consisted of Gilchrist brace immobilization and progressive physical therapy.

Main Results:

• Twenty-three patients completed a 2-year follow-up, showing a significant improvement in the Constant Score from 21 to 58 (p < 0.001).
• Significant reductions in pain and improvements in active elevation (37.2° to 65°), internal rotation (14.8% to 50%), and external rotation (11.3% to 47.5%) were observed.
• The overall complication rate was 20%, with five major complications requiring implant removal.

Conclusions:

• The EPOCA RECO shoulder reconstruction is an effective salvage procedure for cuff tear arthropathy, significantly improving pain and function.
• Despite a notable complication rate, patient satisfaction was high, with all participants indicating willingness to undergo the procedure again.