Clinical and radiographic outcomes of revision to reverse shoulder arthroplasty with an augmented baseplate in the setting of glenoid bone loss.

Abstract

Background: In revision to reverse shoulder arthroplasty (RSA), improper correction of glenoid deformity can result in over-medialization, baseplate fixation compromise, or variation in baseplate inclination or version. This study assessed clinical and radiographic outcomes of a non-custom augmented baseplate in the setting of revision to RSA.

Methods: This was a retrospective cohort study of patients who underwent revision to RSA (from a prior shoulder arthroplasty procedure) with an augmented baseplate with a minimum 2-year follow-up. Radiographic and clinical outcomes were assessed.

Results: Revision to RSA with a baseplate augment was performed in 25 patients (age 68.2 ± 8.9 years). There was improvement in elevation (98 to 146, p < 0.001), external rotation (28 to 39, p = 0.032), American Shoulder and Elbow Surgeon score (36.5 to 75.4, p < 0.001), Single Alpha Numeric Evaluation score (30.1 to 70.0, p < 0.001), and Visual Analog Pain Score (6.2 to 2.3, p < 0.001). One patient had radiographic evidence of baseplate mechanical failure (4%), two cases had postoperative instability (8%), and two cases had periprosthetic humerus fractures (8%).

Discussion: In the setting of glenoid bone loss and revision to RSA, baseplate full and half-wedge "off-the-shelf" augments provide favorable short-term outcomes with a low rate of baseplate failure (4%) at a mean 2.7-year follow-up.

Level of evidence: Level IV, retrospective cohort study.