Baseplate version in reverse shoulder arthroplasty: does excessive retroversion or anteversion affect functional...

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Arthroplasty

Background:

• Reverse shoulder arthroplasty (RSA) is a common procedure for complex shoulder conditions.
• Restoring neutral baseplate version is often attempted using bone grafting or augmented components.
• The clinical significance of non-neutral baseplate version in RSA remains unclear.

Purpose of the Study:

• To compare clinical outcomes of RSA baseplates with high degrees of retroversion and anteversion versus those in neutral version.
• To evaluate the impact of baseplate version on patient-reported outcomes and functional limitations.

Main Methods:

• Retrospective comparative study of RSA patients with a minimum two-year follow-up.
• Post-operative radiographs were used to categorize baseplate version into four groups: neutral, moderate anteversion, moderate retroversion, and severe retroversion.
• Outcomes assessed included functional rotation (internal, external, cross-body adduction), complications, and revisions using Simple Shoulder Test (SST) and American Shoulder and Elbow Surgeons (ASES) scores.

Main Results:

• No significant differences in final SST, ASES scores, or change in SST were observed across the four baseplate version groups.
• While most functional limitations showed no difference, patients with moderate to severe anteversion reported more difficulty with activities like putting on a coat.
• No significant differences in complication or revision rates were found between the groups.

Conclusions:

• High degrees of baseplate retroversion or anteversion in RSA are not associated with inferior patient-reported outcomes or functional rotation.
• The study suggests that significant version correction may not be necessary in all RSA cases.
• Further research could explore specific patient factors influencing outcomes in non-neutral baseplate positions.