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Reverse Total Shoulder Arthroplasty
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Scapular Notching in Reverse Total Shoulder Arthroplasty.

Richard Joel Friedman1, David Anthony Barcel, Josef Karl Eichinger

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The Journal of the American Academy of Orthopaedic Surgeons
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PubMed
Summary

Scapular notching, an erosion after reverse total shoulder arthroplasty, is linked to implant design and surgical technique. Further research is needed for optimal prevention and treatment strategies.

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Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Biomedical Engineering

Background:

  • Scapular notching is a frequent radiographic observation post-reverse total shoulder arthroplasty.
  • It involves erosive lesions at the inferior scapular neck due to humeral implant impingement during adduction.

Purpose of the Study:

  • To review the incidence, severity, and contributing factors of scapular notching.
  • To discuss the clinical significance and potential consequences of scapular notching.
  • To explore current knowledge on prevention and treatment strategies.

Main Methods:

  • Review of radiographic findings and clinical outcomes.
  • Analysis of prosthetic design elements (glenosphere size, shape, position, neck-shaft angle, offset).
  • Evaluation of surgical technique and native scapular anatomy considerations.

Main Results:

  • Scapular notching incidence and severity correlate with prosthetic design and surgical technique.
  • Factors like lateral offset, glenosphere overhang, and presurgical glenoid morphology influence notching.
  • Potential complications include functional decline and glenoid implant failure.

Conclusions:

  • The clinical importance of scapular notching remains unclear.
  • Optimal management strategies for severe notching are not yet established.
  • Further research is essential to guide prevention and treatment.