2021 ISAKOS Biennial Congress ePoster
Reverse Total Shoulder Arthroplasty For Glenoid Bone Loss Without A Rotator Cuff Tear: A Concise Follow Up At A Minimum Of Five Years
Stephen C. Weber, MD, San Diego, CA UNITED STATES
Edward G. McFarland, Lutherville, MD UNITED STATES
Prashant Meshram, MBBS, MS, DNB (Ortho), Dubai, Dubai UNITED ARAB EMIRATES
Jorge Rojas Llevano, MD, Bogata, Columbia COLOMBIA
Jacob Joseph, BS, Baltimore, MD UNITED STATES
Uma Srikumaran, MD, MBA, MPH, Columbia, MD UNITED STATES
The Johns Hopkins School of Medicine, Baltimore, MD, UNITED STATES
FDA Status Cleared
Summary
Minimum five-year follow-up of 29 RTSA patients without bone grafting for osteoarthritis with significant bone loss
ePosters will be available shortly before Congress
Abstract
Background
When performing reverse total shoulder arthroplasty in patients with limited glenoid bone, one of the treatment options is to ream the glenoid flat without bone grafting. The purpose of this study was to evaluate the outcomes of this technique in a previously reported cohort after a minimum of 5 years in terms of implant survival, clinical results, and radiographic findings.
Methods
Survival was defined as a revision for any cause or baseplate failure with evidence of loosening. Clinical results at follow up included a VAS for pain, patient related outcome scores, and range of shoulder motion. Radiographic evaluation included notching, baseplate loosening, and baseplate failure. Notching was evaluated by two observers using the system of Nerot-Sirveaux.
Results
Of the original cohort of 42 patients, 7 had died and 4 were lost to follow up. The remaining 29 patients (31 shoulders) were contacted for follow up at a minimum of 5 years (range, 60 to 141 months). Implant survivorship in those patients at a minimum of 60 months was 97%. If one includes the 1patient who had a failed RTSA prior to 2 years, the overall survivorship at 5 year follow up was 94%. The patients who did not have an implant failure had statistically and clinically significant differences from preoperative to postoperative for the VAS for pain, the modified ASES score, the Simple Shoulder Test, and the SF-36 scores. Radiographic evaluation demonstrated notching in 6 patients (19%) with 2 with grade 1 notching, 2 with grade 2 notching, 1 with grade 3 notching, and 1 with grade 4 notching.
Conclusions
For patients with osteoarthritis, glenoid bone loss, and an intact rotator cuff, reaming the glenoid flat has excellent survival and clinical results at a minimum of 5 year follow up. While this technique can be successful in addressing glenoid bone loss for this indication, longer term outcomes and the limit of bone loss which can be addressed with this technique requires further study.