2025 ISAKOS Biennial Congress ePoster
Glenoid Component Removal Methods In Revision Reverse Total Shoulder Arthroplasty
Stephen C. Weber, MD, San Diego, CA UNITED STATES
Piotr Lukasiewicz, MD, PhD, Lublin POLAND
Edward G McFarland, MD, FAAOS, Baltimore, Maryland UNITED STATES
The Johns Hopkins School of Medicine, Baltimore, Maryland, UNITED STATES
FDA Status Cleared
Summary
Currently available literature frequently does not provide information on glenosphere or reverse baseplate removal techniques
ePosters will be available shortly before Congress
Abstract
Introduction
This is the attempt to gather and compare data on available reverse total shoulder arthroplasty systems with special consideration of the glenoid componDescribe what was actually done.
Method
We searched online for all available RTSA systems currently on or off the market. For each system found, we obtained current literature from the manufacturers whenever available. For each system we determined the type of glenoid baseplate fixation to the glenoid. These include a central peg, a central screw or both as methods of fixation of the glenoid baseplate. We also determined the presence or absence of detailed instructions in the manufacturer literature about how to remove the glenoid components. The methods for each system for removing the glenoid sphere from the baseplate were explored. When there were instructions on removing the sphere or the baseplate, it was determined if there was special equipment necessary for removal of the glenoid implants. An attempt was made to determine and classify the removal systems for the available extraction strategies. Lastly, we reviewed the existing literature for evidence of discussion on the removal of glenoid baseplates and spheres in revision of RTSA.
Results
Overall, we found 40 RTSA systems on and off the market as of March 2024. Of these systems, the method of fixation of the baseplate to the glenoid as a central peg was found in 17 (42.5%) designs, a central screw in 6 (15.0%), both a central peg with screw in 6 (15.0%), central peg or screw in 2 (5.0%) and other or unspecified due to lack of available instructions and technical literature in 9 (22.5%) designs.
Of the systems evaluated 30 (75.0%) had surgical techniques available online. Only 22 (55.0%) of these surgical techniques had any mention of techniques or instrumentation for removal of the glenoid sphere and 14 (35.0%) for baseplate removal. The techniques described for removing the glenoid sphere from the baseplate included dedicated tools in 15 of 22 available instructions. To remove the baseplate of the systems studied, there was a mention of dedicated tools in 10 out of 14 designs with available surgical techniques.
Conclusion
This study found that of available RTSA systems, a minority describe how to either remove a glenoid sphere from a baseplate or how to remove a baseplate from the glenoid. The literature search shows that there is a need for expanding and supplementing the existing instructions as those often lack clear steps and hints on glenoid component removal. Further research and potential clinical studies would be helpful to systematize best approaches and avoid potential mistakes.