Primary and Revision Reverse Shoulder Arthroplasty Using Custom-Made 3D-Printed Baseplates for Severe Multiplanar...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Implant Design

Background:

• Severe glenoid bone loss complicates primary and revision reverse shoulder arthroplasty (RSA).
• Standard implants struggle with fixation in cases of significant bone deficiency.
• Custom 3D-printed glenoid components offer a tailored solution for anatomical fit and secure fixation.

Purpose of the Study:

• To evaluate the clinical and radiographic outcomes of custom-made glenoid implants for severe glenoid bone loss.
• To compare outcomes between primary and revision RSA using custom implants.
• To assess the reliability and stability of patient-specific glenoid components.

Main Methods:

• Retrospective, multicenter study of 23 shoulders (11 primary, 12 revision RSA) using custom 3D-printed glenoid components (Enovis ProMade System).
• Minimum 24-month follow-up with CT-based 3D modeling for patient-specific implant design and instrumentation.
• Assessment of clinical outcomes (ROM, pain, Constant-Murley score) and radiographic results, with statistical comparison between primary and revision groups.

Main Results:

• Significant improvements in shoulder mobility, pain reduction, and Constant-Murley scores observed in both primary and revision RSA groups (p < 0.001).
• No significant differences in functional improvement (delta scores) between primary and revision groups.
• Excellent radiographic outcomes with no implant loosening, minimal radiolucent lines, and low complication rates; four cases of instability occurred in the revision group.

Conclusions:

• Custom-made glenoid implants are a reliable solution for severe glenoid bone loss in both primary and revision RSA.
• These patient-specific implants achieve consistent functional improvements and high implant stability.
• Further prospective studies are recommended to validate long-term efficacy and cost-effectiveness.