Reverse Shoulder Arthroplasty with Bony and Metallic versus Standard Bony Reconstruction for Severe Glenoid Bone Loss. A Retrospective Comparative Cohort Study
There are different techniques to address severe glenoid erosion during reverse shoulder arthroplasty (RSA). This study assessed the clinical and radiological outcomes of RSA with combined bony and metallic augment (BMA) glenoid reconstruction compared to bony augmentation (BA) alone. A review of pa...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/22/5274 |
| _version_ | 1797509874766053376 |
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| author | Marko Nabergoj Lionel Neyton Hugo Bothorel Sean W. L. Ho Sidi Wang Xue Ling Chong Alexandre Lädermann |
| author_facet | Marko Nabergoj Lionel Neyton Hugo Bothorel Sean W. L. Ho Sidi Wang Xue Ling Chong Alexandre Lädermann |
| author_sort | Marko Nabergoj |
| collection | DOAJ |
| description | There are different techniques to address severe glenoid erosion during reverse shoulder arthroplasty (RSA). This study assessed the clinical and radiological outcomes of RSA with combined bony and metallic augment (BMA) glenoid reconstruction compared to bony augmentation (BA) alone. A review of patients who underwent RSA with severe glenoid bone loss requiring reconstruction from January 2017 to January 2019 was performed. Patients were divided into two groups: BMA versus BA alone. Clinical outcome measurements included two years postoperative ROM, Constant score, subjective shoulder value (SSV), and the American Shoulder and Elbow Surgeons Shoulder (ASES) score. Radiological outcomes included radiographic evidence of scapular complications and graft incorporation. The BMA group had significantly different glenoid morphology (<i>p</i> < 0.001) and greater bone loss thickness than the BA group (16.3 ± 3.8 mm vs. 12.0 ± 0.0 mm, <i>p</i> = 0.020). Both groups had significantly improved ROM (anterior forward flexion and external rotation) and clinical scores (Constant, SSV and ASES scores) at 2 years. Greater improvement was observed in the BMA group in terms of anterior forward flexion (86.3° ± 27.9° vs. 43.8° ± 25.6°, <i>p</i> = 0.013) and Constant score (56.6 ± 10.1 vs. 38.3 ± 16.7, <i>p</i> = 0.021). The BA group demonstrated greater functional and clinical improvements with higher postoperative active external rotation and ASES results (active external rotation, 49.4° ± 17.0° vs. 29.4° ± 14.7°, <i>p</i> = 0.017; ASES, 89.1 ± 11.3 vs. 76.8 ± 11.0, <i>p</i> = 0.045). The combination use of bone graft and metallic augments in severe glenoid bone loss during RSA is safe and effective and can be considered in cases of severe glenoid bone loss where bone graft alone may be insufficient. |
| first_indexed | 2024-03-10T05:23:54Z |
| format | Article |
| id | doaj.art-a63d728ed7cc4ed998de2e17cc6ee1ee |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T05:23:54Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-a63d728ed7cc4ed998de2e17cc6ee1ee2023-11-22T23:48:58ZengMDPI AGJournal of Clinical Medicine2077-03832021-11-011022527410.3390/jcm10225274Reverse Shoulder Arthroplasty with Bony and Metallic versus Standard Bony Reconstruction for Severe Glenoid Bone Loss. A Retrospective Comparative Cohort StudyMarko Nabergoj0Lionel Neyton1Hugo Bothorel2Sean W. L. Ho3Sidi Wang4Xue Ling Chong5Alexandre Lädermann6Valdoltra Orthopaedic Hospital, 6280 Ankaran, SloveniaRamsay Générale de Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, 69008 Lyon, FranceResearch Department, La Tour Hospital, 1217 Meyrin, SwitzerlandDepartment of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore 308433, SingaporeDivision of Orthopaedics and Trauma Surgery, La Tour Hospital, 1217 Meyrin, SwitzerlandDivision of Orthopaedics and Trauma Surgery, La Tour Hospital, 1217 Meyrin, SwitzerlandDivision of Orthopaedics and Trauma Surgery, La Tour Hospital, 1217 Meyrin, SwitzerlandThere are different techniques to address severe glenoid erosion during reverse shoulder arthroplasty (RSA). This study assessed the clinical and radiological outcomes of RSA with combined bony and metallic augment (BMA) glenoid reconstruction compared to bony augmentation (BA) alone. A review of patients who underwent RSA with severe glenoid bone loss requiring reconstruction from January 2017 to January 2019 was performed. Patients were divided into two groups: BMA versus BA alone. Clinical outcome measurements included two years postoperative ROM, Constant score, subjective shoulder value (SSV), and the American Shoulder and Elbow Surgeons Shoulder (ASES) score. Radiological outcomes included radiographic evidence of scapular complications and graft incorporation. The BMA group had significantly different glenoid morphology (<i>p</i> < 0.001) and greater bone loss thickness than the BA group (16.3 ± 3.8 mm vs. 12.0 ± 0.0 mm, <i>p</i> = 0.020). Both groups had significantly improved ROM (anterior forward flexion and external rotation) and clinical scores (Constant, SSV and ASES scores) at 2 years. Greater improvement was observed in the BMA group in terms of anterior forward flexion (86.3° ± 27.9° vs. 43.8° ± 25.6°, <i>p</i> = 0.013) and Constant score (56.6 ± 10.1 vs. 38.3 ± 16.7, <i>p</i> = 0.021). The BA group demonstrated greater functional and clinical improvements with higher postoperative active external rotation and ASES results (active external rotation, 49.4° ± 17.0° vs. 29.4° ± 14.7°, <i>p</i> = 0.017; ASES, 89.1 ± 11.3 vs. 76.8 ± 11.0, <i>p</i> = 0.045). The combination use of bone graft and metallic augments in severe glenoid bone loss during RSA is safe and effective and can be considered in cases of severe glenoid bone loss where bone graft alone may be insufficient.https://www.mdpi.com/2077-0383/10/22/5274shoulderprosthesisdefectreconstructionautologous graftsurvivorship |
| spellingShingle | Marko Nabergoj Lionel Neyton Hugo Bothorel Sean W. L. Ho Sidi Wang Xue Ling Chong Alexandre Lädermann Reverse Shoulder Arthroplasty with Bony and Metallic versus Standard Bony Reconstruction for Severe Glenoid Bone Loss. A Retrospective Comparative Cohort Study Journal of Clinical Medicine shoulder prosthesis defect reconstruction autologous graft survivorship |
| title | Reverse Shoulder Arthroplasty with Bony and Metallic versus Standard Bony Reconstruction for Severe Glenoid Bone Loss. A Retrospective Comparative Cohort Study |
| title_full | Reverse Shoulder Arthroplasty with Bony and Metallic versus Standard Bony Reconstruction for Severe Glenoid Bone Loss. A Retrospective Comparative Cohort Study |
| title_fullStr | Reverse Shoulder Arthroplasty with Bony and Metallic versus Standard Bony Reconstruction for Severe Glenoid Bone Loss. A Retrospective Comparative Cohort Study |
| title_full_unstemmed | Reverse Shoulder Arthroplasty with Bony and Metallic versus Standard Bony Reconstruction for Severe Glenoid Bone Loss. A Retrospective Comparative Cohort Study |
| title_short | Reverse Shoulder Arthroplasty with Bony and Metallic versus Standard Bony Reconstruction for Severe Glenoid Bone Loss. A Retrospective Comparative Cohort Study |
| title_sort | reverse shoulder arthroplasty with bony and metallic versus standard bony reconstruction for severe glenoid bone loss a retrospective comparative cohort study |
| topic | shoulder prosthesis defect reconstruction autologous graft survivorship |
| url | https://www.mdpi.com/2077-0383/10/22/5274 |
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