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Updated: Sep 23, 2025

Reverse Total Shoulder Arthroplasty

Reverse Total Shoulder Arthroplasty

Published on: July 5, 2011

Does lateralizing the glenosphere center of rotation by 4 mm decrease scapular notching in reverse shoulder

Samuel M Harmsen^1,2, Joey Robaina², David Campbell²

¹TOCA at Banner Health, Phoenix, AZ, USA.

JSES International

|May 16, 2022

Summary

Lateralizing glenosphere center of rotation (COR) in reverse shoulder arthroplasty (RSA) with a 135° neck-shaft angle (NSA) did not reduce scapular notching or improve outcomes. Scapular notching did not negatively impact clinical results in this study.

Keywords:

135° neck-shaft angle Center of rotation Lateralization Reverse shoulder arthroplasty Scapular notching

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Published on: February 10, 2015

Area of Science:

Orthopedic surgery
Biomechanical engineering
Radiology

Background:

Scapular notching is a known complication of reverse shoulder arthroplasty (RSA).
Lowering the humeral neck-shaft angle (NSA) and lateralizing the glenosphere center of rotation (COR) are strategies to reduce notching.
The effect of glenosphere COR lateralization in lower NSA RSA is not well understood.

Purpose of the Study:

To compare the impact of medialized COR (MCOR, 0 mm) versus lateralized COR (LCOR, 4 mm) on scapular notching incidence.
To evaluate clinical outcomes in RSA with a 135° NSA humeral component and varying glenosphere COR.
To determine if glenosphere COR lateralization affects outcomes in RSA with a 135° NSA.

Main Methods:

Multicenter retrospective comparative cohort study of 82 patients undergoing RSA with a 135° NSA humeral component.
Patients were divided into two groups: MCOR (0 mm) and LCOR (4 mm).
Radiographic evaluation for scapular notching and clinical outcome assessment (ASES, VAS, SANE, ROM) at 2-year follow-up.

Main Results:

Overall scapular notching incidence was 22.0%, with no significant difference between MCOR (24.4%) and LCOR (19.5%) cohorts.
Both groups showed significant improvements in all clinical outcome measures postoperatively.
Improvements in clinical outcomes and range of motion did not significantly differ between the MCOR and LCOR groups.
Scapular notching did not negatively impact any clinical outcome measure.

Conclusions:

Lateralizing the glenosphere COR by 4 mm does not significantly reduce scapular notching in 135° NSA RSA at short-term follow-up.
Glenosphere COR lateralization did not significantly improve functional outcomes or range of motion compared to medialized COR.
Scapular notching did not adversely affect clinical outcomes or complication rates in this RSA series.