Early clinical and radiological outcomes of reverse shoulder arthroplasty with an eccentric all-polyethylene glenosphere to treat failed hemiarthroplasty and the sequelae of proximal humeral fractures.
The aim of this study was to assess the effectiveness of reverse total shoulder arthroplasty (RTSA) with an all-polyethylene glenosphere in patients with failed hemiarthroplasty (HH) or the sequelae of proximal humeral fractures.



Thirty-six patients were assessed at a mean follow-up of 36 months using clinical scores and recording shoulder range of movement (ROM).



Active anterior elevation (p < 0.001), lateral elevation (p < 0.001) and internal rotation (p < 0.0001) improved significantly, whereas improvement in external rotation was not significant. The mean Constant score rose significantly from 8.5 ± 7.6 to 40.7 ± 15.7 (p < 0.001) and the Simple Shoulder Test score from 0.42 ± 0.85 to 5.5 ± 2.6 (p < 0.001). Pain improved significantly from 8.7 ± 0.9 to 2.3 ± 1.2 (p < 0.001). Implant radiographic survivorship was 84.6 %. Scapular notching was detected in 7/36 patients (17.5 %). There were five complications: one (stiffness) among patients with fracture sequelae and four among those with failed HH (instability, n = 2; humeral component disassembly, n = 1; pain, n = 1). The two groups did not exhibit significant differences in pain, clinical scores or ROM.



RTSA with an all-polyethylene glenosphere may have the potential to reduce the risk of biological notching due to polyethylene osteolysis. Further long-term studies are required to assess its efficacy.



The good clinical performance and reasonable rate of notching of the polyethylene glenosphere support its use in primary and revision shoulder arthroplasty.



Level 4, retrospective therapeutic case series.
Unit of Shoulder and Elbow Surgery, D. Cervesi Hospital, Via L.V Beethoven 5, 47841, Cattolica, Rimini, Italy. giovannimerolla@hotmail.com.|Biomechanics Laboratory "Marco Simoncelli", D. Cervesi Hospital, Cattolica, Rimini, Italy. giovannimerolla@hotmail.com.
Giovanni
G
Merolla
Unit of Shoulder and Elbow Surgery, D. Cervesi Hospital, Via L.V Beethoven 5, 47841, Cattolica, Rimini, Italy.
Antonio
A
Tartarone
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
John W
JW
Sperling
Unit of Shoulder and Elbow Surgery, D. Cervesi Hospital, Via L.V Beethoven 5, 47841, Cattolica, Rimini, Italy.
Paolo
P
Paladini
Research and Innovation Department, AUSL della Romagna, Ambito Territoriale di Rimini, Rimini, Italy.
Elisabetta
E
Fabbri
Unit of Shoulder and Elbow Surgery, D. Cervesi Hospital, Via L.V Beethoven 5, 47841, Cattolica, Rimini, Italy.
Giuseppe
G
Porcellini
D000368:Aged; D000072228:Arthroplasty, Replacement, Shoulder / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D062785:Hemiarthroplasty / Q000009:adverse effects*; D006801:Humans; D006811:Humerus / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020959:Polyethylene / Q000009:adverse effects / Q000627:therapeutic use; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012784:Shoulder Fractures / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D000072227:Shoulder Prosthesis / Q000009:adverse effects*; D016896:Treatment Outcome
D020959:Polyethylene
Failed hemiarthroplasty; Fracture sequelae; Polyethylene glenosphere; Reverse arthroplasty; Shoulder