Skip to main content
SpringerLink
Log in

Mini-augmented glenoid baseplate and mini-humeral tray reverse total shoulder arthroplasty implant comparisons: two-year clinical outcomes

  • Original Article
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Augmented glenoid baseplate and offset humeral tray reverse total shoulder arthroplasty (RTSA) implants may decrease the mechanical impingement that creates scapular notching and improve shoulder function. This study evaluated the clinical efficacy of three different RTSA glenoid baseplate and offset humeral tray combinations for patient-reported shoulder function, pain and instability, radiographic imaging evidence of glenoid baseplate or humeral stem subsidence and migration, bony changes associated with implant loosening, and scapular notching over the initial 2 years post-RTSA. Primary outcomes included active shoulder mobility, perceived function, pain, instability, scapular notching, and implant survival.

Methods

Sixty-seven patients from 6 research sites received one of three different glenoid baseplate and humeral tray combinations. Group 1 (n = 21) received a mini-augmented glenoid baseplate with a standard humeral tray; Group 2 (n = 23) received a standard glenoid baseplate and a mini-humeral tray with 3 trunnion offset options; Group 3 (n = 23) received both a mini-augmented glenoid baseplate and a mini-humeral tray with 3 trunnion offset options. Subjects underwent radiologic evaluation, completed the ASES scale, the EQ-5D-5L quality of life scale, VAS shoulder pain and instability questions, and active shoulder mobility measurements pre-operatively, and 6-weeks, 6-months, 1–2 years post-RTSA.

Results

Improved active shoulder mobility, quality of life, perceived function, decreased shoulder pain and instability, excellent implant survival and minimal scapular notching were observed for all groups. Group 3 had better overall active shoulder mobility than the other groups and better perceived function than Group 1.

Conclusion

The group that received the mini-augmented glenoid baseplate and mini-humeral tray combination had better overall active shoulder flexion, external rotation at 90° abduction, and internal rotation. This group also had better perceived shoulder function compared to the group that received a mini-augmented glenoid baseplate with a standard humeral tray.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Sears BW, Johnston PS, Ramsey ML, Williams GR (2012) Glenoid bone loss in primary total shoulder arthroplasty: evaluation and management. J Am Acad Orthop Surg 20(9):604–613

    PubMed  Google Scholar 

  2. Jones RB, Wright TW, Zuckerman JD (2016) Reverse total shoulder arthroplasty with structural bone grafting of large glenoid defects. J Shoulder Elb Surg 25(9):1425–1432

    Google Scholar 

  3. Ernstbrunner L, Werthel JD, Wagner E, Hatta T, Sperling JW, Cofield RH (2017) Glenoid bone grafting in primary reverse total shoulder arthroplasty. J Shoulder Elb Surg 26(8):1441–1447

    Google Scholar 

  4. Friedman LGM, Garrigues GE (2021) Management of humeral and glenoid bone defects in reverse shoulder arthroplasty. J Am Acad Orthop Surg 29(17):e846–e859

    PubMed  Google Scholar 

  5. Neer CS, Morrison DS (1988) Glenoid bone-grafting in total shoulder arthroplasty. J Bone Joint Surg Am 70:1154–1162

    PubMed  Google Scholar 

  6. Lanham NS, Peterson JR, Ahmed R, Jobin CM, Levine WN (2022) Comparison of glenoid bone grafting versus augmented glenoid baseplates in reverse shoulder arthroplasty: a systematic review. J Shoulder Elb Surg S1058–2746(22)00326–3

    Google Scholar 

  7. Gerber C, Pennington SD, Nyffeler RW (2009) Reverse total shoulder arthroplasty. J Am Acad Orthop Surg 17(5):284–295

    PubMed  Google Scholar 

  8. Nicholson GP, Strauss EJ, Sherman SL (2011) Scapular notching: recognition and strategies to minimize clinical impact. Clin Orthop Relat Res 469(9):2521–2530

    PubMed  Google Scholar 

  9. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) (2020) Hip, knee & shoulder arthroplasty: 2020 annual report. AOA; 2000. P 8 https://aoanjrr.sahmri.com/annualreports 2020

  10. Denard PJ, Walch G (2013) Current concepts in the surgical management of primary glenohumeral arthritis with a bioconcave glenoid. J Shoulder Elb Surg 22(11):1589–1598

    Google Scholar 

  11. Hsu JE, Ricchetti ET, Huffman GR, Iannotti JP, Glaser DL (2013) Addressing glenoid bone deficiency and asymmetric posterior erosion in shoulder arthroplasty. J Shoulder Elb Surg 22(9):1298–1308

    Google Scholar 

  12. McFarland EG, Meshram P, Rojas J, Joseph J, Srikumaran U (2021) Reverse total shoulder arthroplasty without bone-grafting for severe glenoid bone loss in patients with osteoarthritis and intact rotator cuff: a concise 5-year follow-up of a previous report. J Bone Jt Surg Am 103(7):581–585

    Google Scholar 

  13. Ghoraishian M, Abboud JA, Romeo AA, Williams GR, Namdari S (2019) Augmented glenoid implants in anatomic total shoulder arthroplasty: review of available implants and current literature. J Shoulder Elb Surg 28:387–395

    Google Scholar 

  14. Gilot GJ (2013) Addressing glenoid erosion in reverse total shoulder arthroplasty. Bull Hosp Jt Dis 71(Suppl 2):S51–S53

    Google Scholar 

  15. Gutiérrez S, Comiskey CA 4th, Luo ZP, Pupello DR, Frankle MA (2008) Range of impingement-free abduction and adduction deficit after reverse shoulder arthroplasty. Hierarchy of surgical and implant-design-related factors. J Bone Joint Surg Am 90(12):2606–2615

    PubMed  Google Scholar 

  16. Klein SM, Dunning P, Mulieri P, Pupello D, Downes K, Frankle MA (2010) Effects of acquired glenoid bone defects on surgical technique and clinical outcomes in reverse shoulder arthroplasty. J Bone Joint Surg Am 92(5):1144–1154

    PubMed  Google Scholar 

  17. Malahias M-A, Chytas D, Kostretzis L, Brilakis E, Fandridis E, Hantes M, Antonogiannakis E (2020) Bone grafting in primary and revision reverse total shoulder arthroplasty for the management of glenoid bone loss: a systematic review. J Orthop 20:78–86

    PubMed  Google Scholar 

  18. Seidl AJ, Williams GR, Boileau P (2016) Challenges in reverse shoulder arthroplasty: addressing glenoid bone loss. Orthopedics 39(1):14–23

    PubMed  Google Scholar 

  19. Simon P, Diaz M, Cusick M, Santoni B, Frankle M (2018) 3D image-based morphometric analysis of the scapular neck length in subjects undergoing reverse shoulder arthroplasty. Clin Anat 31(1):43–55

    CAS  PubMed  Google Scholar 

  20. Kolmodin J, Davidson IU, Jun BJ, Sodhi N, Subhas N, Patterson TE, Li ZM, Iannotti JP, Ricchetti ET (2018) Scapular notching after reverse total shoulder arthroplasty: prediction using patient-specific osseous anatomy, implant location, and shoulder motion. J Bone Jt Surg Am 100(13):1095–1103

    Google Scholar 

  21. Kowalsky MS, Galatz LM, Shia DS, Steger-May K, Keener JD (2012) The relationship between scapular notching and reverse shoulder arthroplasty prosthesis design. J Shoulder Elb Surg 21(10):1430–1441

    Google Scholar 

  22. Werner BC, Wong AC, Mahony GT, Craig EV, Dines DM, Warren RF, Gulotta LV (2016) Causes of poor postoperative improvement after reverse total shoulder arthroplasty. J Shoulder Elb Surg 25(8):e217–e222

    Google Scholar 

  23. Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Molé D (2004) Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Jt Surg Br 86(3):388–395

    CAS  Google Scholar 

  24. Smith T, Bäunker A, Krämer M, Hurschler C, Kaufmann M, Pastor MF, Wellmann M (2015) Biomechanical evaluation of inferior scapula notching of reverse shoulder arthroplasty depending on implant configuration and scapula neck anatomy. Int J Shoulder Surg 9(4):103–109

    PubMed  PubMed Central  Google Scholar 

  25. Spiry C, Berhouet J, Agout C, Bacle G, Favard L (2021) Long-term impact of scapular notching after reverse shoulder arthroplasty. Int Orthop 45(6):1559–1566

    CAS  PubMed  Google Scholar 

  26. Zitkovsky HS, Carducci MP, Mahendraraj KA, Grubhofer F, Jawa A (2020) Lateralization and decreased neck-shaft angle reduces scapular notching and heterotopic ossification. J Am Acad Orthop Surg 28(23):e1073–e1080

    PubMed  Google Scholar 

  27. Friedman RJ, Barcel DA, Eichinger JK (2019) Scapular notching in reverse total shoulder arthroplasty. J Am Acad Orthop Surg 27(6):200–209

    PubMed  Google Scholar 

  28. Jang YH, Lee JH, Kim SH (2020) Effect of scapular notching on clinical outcomes after reverse total shoulder arthroplasty. Bone Jt J 102B(11):1438–1445

    Google Scholar 

  29. Navarro RA (2021) Long-term value may determine if RTSA for cuff-intact osteoarthritis with glenoid defects does not require bone grafts or augments: commentary on an article by Edward G. McFarland, MD, et al.: “reverse total shoulder arthroplasty without bone-grafting for severe glenoid bone loss in patients with osteoarthritis and intact rotator cuff. A concise 5-year follow-up of a previous report.” J Bone Jt Surg Am 103(7):e30

    Google Scholar 

  30. Simovitch R, Flurin PH, Wright TW, Zuckerman JD, Roche C (2019) Impact of scapular notching on reverse total shoulder arthroplasty midterm outcomes: 5-year minimum follow-up. J Shoulder Elb Surg 28(12):2301–2307

    Google Scholar 

  31. Arashiro Y, Izaki T, Miyake S, Shibata T, Yoshimura I, Yamamoto T (2022) Influence of scapular neck length on the extent of impingement-free adduction after reverse total shoulder arthroplasty. J Shoulder Elb Surg 31(1):185–191

    Google Scholar 

  32. Erickson BJ, Harris JD, Romeo AA (2016) The effect of humeral inclination on range of motion in reverse total shoulder arthroplasty: a systematic review. Am J Orthop (Belle Mead NJ) 45(4):E174-179

    PubMed  Google Scholar 

  33. Lévigne C, Boileau P, Favard L, Garaud P, Molé D, Sirveaux F, Walch G (2008) Scapular notching in reverse shoulder arthroplasty. J Shoulder Elb Surg 17(6):925–935

    Google Scholar 

  34. Zimmer Biomet Reverse Shoulder System Surgical Technique. https://www.zimmerbiomet.com/content/dam/zimmer-biomet-OUS-Surg-techniques/shoulder/comprehensive-reverse-shoulder-system-surgical-technique1.pdf. Downloaded from website on February 10. 2023

  35. Boudreau S, Boudreau ED, Higgins LD, Wilcox RB 3rd (2007) Rehabilitation following reverse total shoulder arthroplasty. J Orthop Sports Phys Ther 37(12):734–743

    PubMed  Google Scholar 

  36. Richards RR, An KN, Bigliani LU, Friedman RJ, Gartsman GM, Gristina AG, Iannotti JP, Mow VC, Sidles JA, Zuckerman JD (1994) A standardized method for the assessment of shoulder function. J Shoulder Elb Surg 3(6):347–352

    CAS  Google Scholar 

  37. Mitsukane M, Suzuki K, Tabe R, Hasumi F, Fukushima D (2022) Normalized hand-behind-back for the measurement of shoulder internal rotation. JSES Int 6(2):287–291

    PubMed  PubMed Central  Google Scholar 

  38. Bercik MJ, Kruse KH, Yalizis M, Gauci MO, Chaoui J, Walch G (2016) A modification to the Walch classification of the glenoid in primary glenohumeral osteoarthritis using three-dimensional imaging. J Shoulder Elb Surg 25(10):1601–1606

    Google Scholar 

  39. Iannotti J, Jun B, Patterson T, Ricchetti E (2017) Quantitative measurement of osseous pathology in advanced glenohumeral osteoarthritis. J Bone Jt Surg 99(17):1460–1468

    Google Scholar 

  40. Walch G, Badet R, Boulahia A, Khoury A (1999) Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplasty 14(6):756–760

    CAS  Google Scholar 

  41. Austin PC (2011) An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multiva Behav Res 46(3):399–424

    Google Scholar 

  42. Bauer JA, Slowinski JJ, Feng L, Sperling JW, Duquin TR (2022) Optimizing glenoid bone preservation in reverse total shoulder arthroplasty using augmented baseplates. JSES Rev Rep Tech 3(1):77–82

    PubMed  PubMed Central  Google Scholar 

  43. Liou W, Yang Y, Petersen-Fitts GR, Lombardo DJ, Stine S, Sabesan VJ (2017) Effect of lateralized design on muscle and joint reaction forces for reverse shoulder arthroplasty. J Shoulder Elb Surg 26(4):564–572

    Google Scholar 

  44. Berhouet J, Kontaxis A, Gulotta LV, Craig E, Warren R, Dines J, Dines D (2015) Effects of the humeral tray component positioning for onlay reverse shoulder arthroplasty design: a biomechanical analysis. J Shoulder Elb Surg 24(4):569–577

    Google Scholar 

  45. Colasanti CA, Lin CC, Ross KA, Luthringer T, Elwell JA, Roche CP, Virk MS, Simovitch RW, Routman HD, Zuckerman JD (2023) Augmented baseplates yield optimum outcomes when compared with bone graft augmentation for managing glenoid deformity during reverse total shoulder arthroplasty: a retrospective comparative study. J Shoulder Elb Surg 32(5):958–971

    Google Scholar 

  46. Michael RJ, Schoch BS, King JJ, Wright TW (2018) Managing glenoid bone deficiency-the augment experience in anatomic and reverse shoulder arthroplasty. Am J Orthop (Belle Mead, NJ). https://doi.org/10.12788/ajo.2018.0014

    Article  PubMed  Google Scholar 

  47. Wright TW, Grey SG, Roche CP, Wright L, Flurin PH, Zuckerman JD (2015) Preliminary results of a posterior augmented glenoid compared to an all polyethylene standard glenoid in anatomic total shoulder arthroplasty. Bull Hosp Jt Dis 73(Suppl 1):S79-S85

    Google Scholar 

  48. Tashjian RZ, Broshinsky K, Stertz I, Chalmers PN (2020) Structural glenoid allograft reconstruction during reverse total shoulder arthroplasty. J Shoulder Elb Surg 29(3):534–540

    Google Scholar 

  49. Ho JC, Sabesan VJ, Iannotti JP (2013) Glenoid component retroversion is associated with osteolysis. J Bone Joint Surg Am 95(12):e82

    PubMed  Google Scholar 

  50. Ho JC, Thakar O, Chan WW, Nicholson T, Williams GR, Namdari S (2020) Early radiographic failure of reverse total shoulder arthroplasty with structural bone graft for glenoid bone loss. J Shoulder Elb Surg 29(3):550–560

    Google Scholar 

Download references

Funding

This study was sponsored by Zimmer Biomet.

Author information

Authors and Affiliations

  1. Norton Orthopedic Institute, 9880 Angies Way Suite 250, Louisville, KY, 40241, USA

    Ryan Krupp & John Nyland

  2. Andrews Research and Education Foundation, Gulf Breeze, FL, USA

    Christopher O’Grady

  3. Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA

    Brian Werner

  4. Department of Orthopedic Surgery, Corewell Health William Beaumont University Hospital, , Royal Oak, MI, USA

    J. Michael Wiater

  5. Department of Orthopaedics, State University of New York at Buffalo, Buffalo, NY, USA

    Thomas Duquin

Authors
  1. Ryan Krupp
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christopher O’Grady
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brian Werner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Michael Wiater
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. John Nyland
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Thomas Duquin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John Nyland.

Ethics declarations

Conflict of interest

Drs. Krupp, O’Grady, Werner, Wiater and Duquin received research support from Zimmer Biomet. Dr. Nyland—has no financial disclosures.

Ethical approval

This study with human subjects by approved by medical institutional review boards.

Informed consent

All study subjects provided written informed consent.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Krupp, R., O’Grady, C., Werner, B. et al. Mini-augmented glenoid baseplate and mini-humeral tray reverse total shoulder arthroplasty implant comparisons: two-year clinical outcomes. Eur J Orthop Surg Traumatol 34, 1045–1056 (2024). https://doi.org/10.1007/s00590-023-03757-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-023-03757-x

Keywords

Search

Navigation