title: Infraglenoidal scapular notching in reverse total shoulder replacement: a prospective series of 60 cases and systematic review of the literature.
abstract: BACKGROUND
  The impact of infraglenoidal scapular notching in reversed total shoulder arthroplasty (RTSA) is still controversially discussed. Our goal was to evaluate its potential influence on subjective shoulder stability and clinical outcome. We hypothesized that subjective instability and clinical outcome after implantation of RTSA correlates with objective scapular notching.
  
  
  METHODS
  Sixty shoulders were assessed preoperatively and at minimum 2-year follow-up for active range of motion and by use of the Oxford instability score, Rowe score for instability, Constant score for pain, Constant shoulder score, DASH score. All shoulders were evaluated on anterior-posterior and axillary lateral radiographic views. These X-ray scans were classified twice by two orthopaedic surgeons with respect to infraglenoidal scapular notching according to the classification of Nerot. Notching was tested for correlation with clinical outcome scores to the evaluated notching.
  
  
  RESULTS
  We found no significant correlation between infraglenoidal scapular notching and clinical outcomes after a mid-term follow-up from 24 to 60 months, but at the final follow-up of 60 months and more, we did see statistically significant, positive correlations between infraglenoidal scapular notching and the Constant pain score as well as active range of motion. At mean follow-up of 42 months (range from 24 to 96 months) we found no significant correlation between subjective instability and infraglenoidal scapular notching.
  
  
  CONCLUSIONS
  We conclude that patients' subjective impression on their shoulders' stability is not correlating with radiological signs of infraglenoidal scapular notching. Nevertheless clinical parameters are affected by infraglenoidal scapular notching, at least in the long term.
authors: Department of Orthopaedic Surgery, Ludwig-Maximilians-University Munich, Campus Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany. patrick.sadoghi@gmx.at
authors: Patrick
authors: P
authors: Sadoghi
authors: Andreas
authors: A
authors: Leithner
authors: Patrick
authors: P
authors: Vavken
authors: Andreas
authors: A
authors: Hölzer
authors: Josef
authors: J
authors: Hochreiter
authors: Georg
authors: G
authors: Weber
authors: Matthias F
authors: MF
authors: Pietschmann
authors: Peter E
authors: PE
authors: Müller
references: J Shoulder Elbow Surg. 2005 Sep-Oct;14(5):524-8
references: 16194746
references: J Bone Joint Surg Br. 2004 Apr;86(3):388-95
references: 15125127
references: J Bone Joint Surg Am. 2007 Mar;89(3):588-600
references: 17332108
references: BMC Musculoskelet Disord. 2003 Jun 16;4:11
references: 12809562
references: Acta Orthop Belg. 2001 Oct;67(4):348-53
references: 11725566
references: J Shoulder Elbow Surg. 2005 Jan-Feb;14(1 Suppl S):147S-161S
references: 15726075
references: BMC Musculoskelet Disord. 2008 Aug 20;9:114
references: 18715495
references: BMC Musculoskelet Disord. 2006 May 18;7:44
references: 16709254
references: J Bone Joint Surg Am. 2005 Aug;87(8):1697-705
references: 16085607
references: Int Orthop. 2010 Feb;34(1):71-7
references: 19221749
references: Int Orthop. 2010 Dec;34(8):1075-82
references: 20865260
references: J Shoulder Elbow Surg. 2011 Oct;20(7):1138-46
references: 21454102
references: Acta Orthop Belg. 2004 Jun;70(3):219-25
references: 15287400
references: J Bone Joint Surg Br. 2004 Nov;86(8):1187-91
references: 15568535
references: J Bone Joint Surg Am. 2005 Jul;87(7):1476-86
references: 15995114
references: Orthopedics. 2002 Feb;25(2):129-33
references: 11866145
references: Am J Orthop (Belle Mead NJ). 2007 Dec;36(12 Suppl 1):22-8
references: 18264554
references: Rev Chir Orthop Reparatrice Appar Mot. 2002 Jun;88(4):410-4
references: 12124542
references: Clin Orthop Relat Res. 2005 Jan;(430):156-62
references: 15662318