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Best Way To Correct Reverse Shoulder Arthroplasty Angle In E1 And E3 Favard’S Glenoids.

Best Way To Correct Reverse Shoulder Arthroplasty Angle In E1 And E3 Favard’S Glenoids.

Michele Paciotti, MD, ITALY Edoardo Franceschetti, MD, ITALY Angelo Baldari, MD, ITALY Edoardo Giovannetti De Sanctis, MD, ITALY Alessio Palumbo, MD, ITALY Francesco Franceschi, MD, Prof, ITALY

Campus Bio-Medico University of Rome, Rome, ITALY


2021 Congress   ePoster Presentation     rating (1)

 

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Sports Medicine

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Summary: The present comparative cohort study demonstrated that the angled BIO-RSA technique is more effective in ensuring a correct inclination of the prosthetic glenoid component and allows to achieve better results in terms of flexion and abduction compared to the standard BIO-RSA technique in patients with rotator cuff injury arthropathy.


Background

In Reverse Shoulder Arthroplasty (RSA) is crucial to avoid a higher inclination of the baseplate and reach a neutral position of the glenoid implant. However, the optimal method to correct native glenoid inclination is still debated.
Different procedures to manage bone defect have been described in the literature. In this study, two surgical techniques have been compared: the Standard BIO-RSA technique, where an eccentric reaming of the glenoid is performed along with a cylindric glenoid bone graft augmentation (BIO-RSA) versus the Angled BIO-RSA technique, including a concentric reaming of the glenoid and the correction of the defect by an angled bone graft.

Methods

A total of 165 patients who underwent Reverse shoulder arthroplasty were analyzed. According to inclusion criteria we excluded 27 patients and finally enrolling 141 shoulders (6 patients underwent surgery for both shoulders). Based on the technique used to manage the glenoid, the patients were divided into two groups: Standard BIO-RSA group and Angled BIO-RSA group. Functional outcome data (ASES, Constant, VAS and ROM) as well as radiographic data were collected pre-operatively, and at 6 months, 1 year and 2 years post-operatively.

Results

Constant score, ASES and VAS did not show significant differences between the two groups (P> 0.05). As regards ROM, statistically significant differences were found in terms of anterior flexion and abduction, with better results for angled BIO-RSA group compared to Standard BIO-RSA group (anterior flexion 149.9° +/- 25.3° versus 139.3° +/- 26.8,° p = 0.019 and abduction 136.4° +/- 24.2° versus 126.7° +/- 29.3°, p = 0.040). Focusing on inferior tilt correction, a statistically significant difference in Postoperative RSA Angle values was found in favour of Angled BIO-RSA (1.252° +/- 6.14° versus 4.09° +/- 8.85°; p = 0.03).

Conclusions

The present comparative cohort study demonstrated that the both techniques were able to correct the glenoid inclination and shows excellent short-term results in patients with rotator cuff injury arthropathy. However, the angled BIO-RSA technique is more effective in ensuring a correct inclination of the prosthetic glenoid component and allows to achieve better results in terms of flexion and abduction


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