title: Scapular notching and osteophyte formation after reverse shoulder replacement: Radiological analysis of implant position in male and female patients.
abstract: This study provides recommendations on the position of the implant in reverse shoulder replacement in order to minimise scapular notching and osteophyte formation. Radiographs from 151 patients who underwent primary reverse shoulder replacement with a single prosthesis were analysed at a mean follow-up of 28.3 months (24 to 44) for notching, osteophytes, the position of the glenoid baseplate, the overhang of the glenosphere, and the prosthesis scapular neck angle (PSNA). A total of 20 patients (13.2%) had a notch (16 Grade 1 and four Grade 2) and 47 (31.1%) had an osteophyte. In patients without either notching or an osteophyte the baseplate was found to be positioned lower on the glenoid, with greater overhang of the glenosphere and a lower PSNA than those with notching and an osteophyte. Female patients had a higher rate of notching than males (13.3% vs 13.0%) but a lower rate of osteophyte formation (22.9% vs 50.0%), even though the baseplate was positioned significantly lower on the glenoid in females (p = 0.009) and each had a similar mean overhang of the glenosphere. Based on these findings we make recommendations on the placement of the implant in both male and female patients to avoid notching and osteophyte formation.
authors.affiliation: Extremities Exactech, Inc., 2320 N W 66th Court, Gainesville, Florida 32653, USA.
authors.forename: C P
authors.initials: CP
authors.lastname: Roche
authors.forename: Y
authors.initials: Y
authors.lastname: Marczuk
authors.forename: T W
authors.initials: TW
authors.lastname: Wright
authors.forename: P-H
authors.initials: PH
authors.lastname: Flurin
authors.forename: S
authors.initials: S
authors.lastname: Grey
authors.forename: R
authors.initials: R
authors.lastname: Jones
authors.forename: H D
authors.initials: HD
authors.lastname: Routman
authors.forename: G
authors.initials: G
authors.lastname: Gilot
authors.forename: J D
authors.initials: JD
authors.lastname: Zuckerman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054850:Osteophyte / Q000000981:diagnostic imaging* / Q000517:prevention & control*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control; D011859:Radiography; D012189:Retrospective Studies; D012540:Scapula / Q000473:pathology*; D012737:Sex Factors; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000601:surgery*