title: A radiographic analysis of the effects of prosthesis design on scapular notching following reverse total shoulder arthroplasty.
abstract: BACKGROUND
  Scapular notching is a well-recognized complication of reverse total shoulder arthroplasty (RTSA). This paper analyzes the effects of prosthesis design on scapular notching in RTSA.
  
  
  METHODS
  From a database of all RTSA performed by the senior author, shoulders with minimum 12-month follow-up were included (65 shoulders). Notching in shoulders with a prosthesis neck-shaft angle of 155° and no center-of-rotation (COR) offset (group 1) was compared to notching in shoulders with a neck-shaft angle of 143° and 2.5-mm COR offset (group 2). P values less than .05 were considered significant.
  
  
  RESULTS
  The notching grade was significantly higher in group 1 than in group 2, even after statistically adjusting for differences in length of follow-up (P = .0081). The incidence of notching in group 1 at 60.7% was significantly higher than the 16.2% incidence in group 2 (P = .0107).
  
  
  CONCLUSIONS
  Using prostheses with a smaller neck-shaft angle and increased COR offset can significantly reduce scapular notching in RTSA at 1 year, possibly improving prosthesis survival.
authors.affiliation: William Beaumont Hospital Department of Orthopaedic Surgery, Royal Oak, MI, USA.
authors.forename: Laurence B
authors.initials: LB
authors.lastname: Kempton
authors.forename: Mamtha
authors.initials: M
authors.lastname: Balasubramaniam
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ankerson
authors.forename: J Michael
authors.initials: JM
authors.lastname: Wiater
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D012086:Reoperation; D000070636:Rotator Cuff Injuries; D012421:Rupture; D012785:Shoulder Joint / Q000503:physiopathology