title: Inferior tilt of the glenoid component does not decrease scapular notching in reverse shoulder arthroplasty: results of a prospective randomized study.
abstract: OBJECTIVE
  The purpose of this study was to determine if inferior tilt of the glenoid component decreased the amount of radiographic scapular notching after reverse shoulder arthroplasty. A secondary goal was to determine if inferior tilt had any effect on clinical outcome.
  
  
  METHODS
  A prospective randomized trial of 52 consecutive reverse shoulder arthroplasties performed by 1 surgeon for cuff tear arthropathy was performed. The subjects were randomly assigned to receive a glenoid component with no inferior tilt (control group) or a glenoid component that was inferiorly tilted 10° to protect the inferior glenoid (inferior tilt group). All glenoid components were placed in 3 mm of inferior translation. Radiographic notching was graded at a minimum of 1 year after surgery. Clinical outcomes of the groups were recorded.
  
  
  RESULTS
  Follow-up radiographs and data were available for 42 subjects, 20 in the inferior tilt group and 22 in the control group. The experimental groups did not differ significantly in the notch ratings or clinical outcomes. Notching occurred in 15 patients (75%) in the inferior tilt group and in 19 (86%) in the control group. Notching scores were 2 or greater in 10 patients (50%) in the inferior tilt group and in 11 (50%) in the control group.
  
  
  CONCLUSIONS
  Placing the glenoid component with inferior tilt does not reduce the incidence or severity of radiographic scapular notching after reverse shoulder arthroplasty. No clinical differences were observed between the groups.
authors.affiliation: Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA. bemd@fondren.com
authors.forename: T Bradley
authors.initials: TB
authors.lastname: Edwards
authors.forename: George J
authors.initials: GJ
authors.lastname: Trappey
authors.forename: Clayton
authors.initials: C
authors.lastname: Riley
authors.forename: Daniel P
authors.initials: DP
authors.lastname: O'Connor
authors.forename: Hussein A
authors.initials: HA
authors.lastname: Elkousy
authors.forename: Gary M
authors.initials: GM
authors.lastname: Gartsman
mesh_terms: D000368:Aged; D001168:Arthritis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D019643:Arthroplasty, Replacement / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects*; D008297:Male; D011446:Prospective Studies; D011475:Prosthesis Failure; D012372:ROC Curve; D011859:Radiography; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012540:Scapula / Q000000981:diagnostic imaging / Q000293:injuries*; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome