title: Reversed shoulder arthroplasty with inversed bearing materials: 2-year clinical and radiographic results in 101 patients.
abstract: BACKGROUND
  This study documents 2-year clinical and radiographic results following reversed total shoulder arthroplasty using a novel prosthesis with inverted bearing materials (polyethylene glenoid; metal humeral component). This design was intended to avoid massive PE abrasion on the humeral side. Therefore, we predicted a lack of subsequent osteolysis-induced exacerbation of scapular notching, and because of other design features and modified operating technique a reduced notching rate.
  
  
  METHODS
  An ongoing, prospective, international, multicenter study of patients implanted with a novel prosthesis at six European centers. The current analysis presents 2-year follow-up data (patients operated between December 2007 and July 2009). Clinical evaluation tools comprised the Constant-Murley score (CS), the American Shoulder and Elbow Surgeon score, range of motion, and a visual analog scale to assess pain and satisfaction. Radiographs were evaluated for notching and radiolucent lines. Any complications were recorded.
  
  
  RESULTS
  In total, 113 prostheses (113 patients) with a mean follow-up of 27.6 (±3.6) months were analyzed. CS increased from 22.5 (±13.7) to 65.3 (±14.9) points (p = 0.06). Inferior scapular notching (only grade 1 and 2) was identified in 20.5 % of patients, with no signs of PE-induced osteolysis. 4.4 % of patients experienced an implant-related complication.
  
  
  CONCLUSIONS
  Inversion of the materials led to another type of notching with no signs of PE-induced osteolysis and no increase in the risk of short-term complications. Clinical results were comparable with other prostheses. Mid- to long-term results are required before any firm conclusions on clinical outcome and survival can be drawn.
authors.affiliation: Department of Orthopaedic Surgery, Marienstift Arnstadt, Wachsenburgallee 12, 99310, Arnstadt, Germany. prof.irlenbusch@sportklinik-erfurt.de.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Irlenbusch
authors.affiliation: Sporthopaedicum Straubing, Bahnhofplatz 27, 94315, Straubing, Germany.
authors.forename: Max J
authors.initials: MJ
authors.lastname: Kääb
authors.affiliation: Hôpital Cantonal Fribourg, Route de Bertigny, 1708, Fribourg, Switzerland.
authors.forename: George
authors.initials: G
authors.lastname: Kohut
authors.affiliation: CHU de Limoges, 2 avenue Martin-Luther-King, 87042, Limoges Cedex, France.
authors.forename: Jerome
authors.initials: J
authors.lastname: Proust
authors.affiliation: DRK Kliniken Berlin Köpenick, Salvador-Allende-Strasse 2-8, 12559, Berlin, Germany.
authors.forename: Falk
authors.initials: F
authors.lastname: Reuther
authors.affiliation: Clinique du Libournais, 119 avenue de la Marne, 33500, Libourne, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Joudet
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000295:instrumentation / Q000379:methods*; D001672:Biocompatible Materials; D002858:Chromium Alloys; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D020959:Polyethylene; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D002858:Chromium Alloys; D020959:Polyethylene