Abstract

Glenoid implant position and fixation are challenging in severe glenoid defects in reverse total shoulder arthroplasty (rTSA). Custom-made glenoid implants are metal augmented implants that are specially produced for a certain defect. They provide the restoration of the joint line and proper fixation. This retrospective data analysis investigated the clinical and radiological outcomes after revision using custom-made glenoid implants. Between 2018 and 2020, nine patients (10 shoulders) with severe glenoid defects underwent revision rTSA using a custom-made glenoid implant (Materialise Glenius or Lima ProMade). The pre- and postoperative Constant Murley Score (CMS), UCLA Score and Subjective Shoulder Value (SSV) were assessed. Postoperative CT scans and X-rays in two planes were available. The minimum follow-up was 12 months, with a mean follow-up of 23.1 months. The mean preoperative CMS, UCLA Score and SSV were 10.9, 4.1 and 11.0, respectively. The mean postoperative CMS, UCLA Score and SSV showed significant increases of 51.7 (<0.001), 22.9 (<0.001) and 52.0 (<0.001), respectively. There were no signs of loosening implants or scapular notching, and no revision was necessary. This trial showed promising clinical and radiological short-term outcomes for custom-made glenoid components in revision rTSA.

Highlights

  • Reverse total shoulder arthroplasty has proven very successful, and an increase in annual surgery is expected in the coming years [1]

  • Glenoid defects classically occur after the infection or loosening of the glenoid implant after total shoulder arthroplasty (TSA) due to cuff arthropathy or rheumatoid arthritis [3]

  • This retrospective data analysis included nine patients (10 shoulders) who were treated with revision reverse total shoulder arthroplasty (rTSA) using a custom-made glenoid implant to address the bone defect by a single senior surgeon in a single institution between 2018 and 2020

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Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Reverse total shoulder arthroplasty (rTSA) has proven very successful, and an increase in annual surgery is expected in the coming years [1]. Revision surgery will be needed more often alongside the more frequent use of rTSA. Complications occur in up to 15% of cases when used in the primary setting and up to 40% of cases when used in the revision setting [2]. One of the most challenging complications surgeons face with rTSA is severe glenoid defects. Glenoid defects classically occur after the infection or loosening of the glenoid implant after total shoulder arthroplasty (TSA) due to cuff arthropathy or rheumatoid arthritis [3]

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