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Short-Term Radiographic Outcomes of Bone Versus Metallic Augmented, Central Screw Type Baseplate in Reverse Total

Eddie Y Lo1,2, Monia Nazemi1,3, Alvin Ouseph1,2

  • 1The Shoulder Center Research, Baylor Scott and White Research Institute, Dallas, TX, USA.

Journal of Shoulder and Elbow Arthroplasty
|June 7, 2024
PubMed
Summary

Metallic augmented baseplates showed no failures in reversed total shoulder arthroplasty (RTSA), while bone grafts had 7% failure. This suggests metallic augmentation may offer superior durability for RTSA glenoid components.

Keywords:
Bio-RSAbaseplate augmentationglenoid augmentationglenoid bone lossradiographic outcomereverse total shoulder arthroplasty

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Radiology

Background:

  • Glenoid bone grafting and metallic augmented baseplates are used in shoulder arthroplasty.
  • No consensus exists on the preferred method for glenoid reconstruction.
  • Restoring the glenohumeral joint line is crucial for successful outcomes.

Purpose of the Study:

  • To compare the failure rates of metallic augmented glenoid baseplates versus bone-grafted glenoid baseplates in primary reversed total shoulder arthroplasty (RTSA).
  • To evaluate the long-term durability and aseptic failure of these two glenoid augmentation techniques.

Main Methods:

  • Retrospective review of 15 primary RTSA with metallic augmented baseplates and 30 primary RTSA with bone graft augmentation (2:1 matching).
  • Exclusion of patients with prior glenoid surgery or fracture.
  • Analysis of radiographic series and 3D CT scans to assess glenoid morphology and component position. Aseptic failure defined as hardware breakage or component shift.

Main Results:

  • No baseplate failures occurred in the metallic augment group (0%) over a mean follow-up of 22.6 months.
  • Two baseplate failures (7%) occurred in the bone graft group at a mean follow-up of 27.3 months.
  • Patients in the bone graft failure group had a mean age of 64.5 years.

Conclusions:

  • Contemporary reversed shoulder arthroplasty glenoid baseplate designs demonstrate a low incidence of failure.
  • Metallic augmentation showed no failures, suggesting potential for improved durability compared to bone grafting.
  • Further research is needed to determine optimal augmentation strategies based on specific glenoid morphology.