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Can small glenospheres with eccentricity reduce scapular notching as effectively as large glenospheres without
Carlos Torrens1, Joan Miquel2, Raquel Martínez1
1Department of Orthopedics, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.
Journal of Shoulder and Elbow Surgery
|December 1, 2019
Summary
Small eccentric glenospheres showed a trend toward increased scapular notch development compared to larger ones, though not statistically significant. Functional outcomes were similar for both reverse shoulder arthroplasty designs.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Radiology
Background:
- Scapular notch development is a concern in reverse shoulder arthroplasty.
- The impact of glenosphere size and eccentricity on this complication requires investigation.
Purpose of the Study:
- To compare scapular notch development between large and small eccentric glenospheres in reverse shoulder arthroplasty.
- To evaluate functional outcomes associated with each glenosphere type.
Main Methods:
- Prospective randomized study of 82 patients undergoing reverse shoulder arthroplasty.
- Comparison of 42-mm (large) vs. 38-mm (small, eccentric) glenospheres.
- Assessment of scapular notch development via radiographs and functional outcomes using the Constant score at 2-year follow-up.
Main Results:
- Scapular notch development occurred in 16.6% of the large glenosphere group and 34.2% of the small eccentric group (P = .07).
- No significant difference in functional outcomes or glenosphere overhang was observed between the groups.
- Functional outcomes did not differ between patients with or without scapular notch development.
Conclusions:
- Small eccentric glenospheres demonstrated a trend towards increased scapular notch development compared to large glenospheres, but without statistical significance.
- Reverse shoulder arthroplasty with either glenosphere size resulted in comparable functional improvements.
- Glenosphere design choice may influence radiographic complications without impacting short-term functional results.
