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Aims <p>In reverse shoulder arthroplasty (RSA), different implant designs range from medializing implants to strongly lateralizing onlay designs with different neck-shaft-angles (NSA). Thus different degrees of lateralization are currently used. Aim of this study was to compare clinical and radiological outcomes of three different implant designs in a homogeneous patient cohort with primary osteoarthritis (OA).</p> Methods <p>Patients with OA who underwent RSA between 03/2014 and 01/2020 were included and categorized into three groups based on RSA design: group MD (medialized-distalized design: eccentric glenosphere, 155° NSA), group L (lateralized design: + 4&#xa0;mm centric glenosphere, 135° NSA), group LD (lateralized-distalized design: eccentric glenospheres, + 3&#xa0;mm baseplate, curved onlay stem 145° NSA). Inclusion criteria were complete clinical and radiological 24&#xa0;months follow-up (FU) including range of motion (ROM), Constant-Murley score (CS), Subjective Shoulder Value (SSV). In addition, scapular notching and adverse events were recorded.</p> Results <p>Group MD including 26 patients (81% female; mean age: 77.9&#xa0;years) reached 71 (range: 60–85) points in CS and 90% (range: 40–100) in SSV. In group L, 46 patients (98% female; mean age: 75.2&#xa0;years) achieved a CS of 75 (59–85) points and SSV was 95% (60–100). In group LD, 25 patients (68% female; mean age: 76.3&#xa0;years) presented a CS of 79 (30–100) points and SSV of 93% (50–100). Group L and group LD achieved significantly better abduction, internal and external rotation (<i>p</i> &lt; 0.001), forward flexion (<i>p</i> = 0.023) and SSV (<i>p</i> = 0.046). Scapular notching was present in 22% of MD patients (13% grade 1; 4% grade 2; 4% grade 4), 16% in group L (all grade 1) and 9% in group LD (all grade 2). No prosthesis related complication occurred in any group.</p> Conclusion <p>In patients with primary OA, the lateralized and lateralized-distalized designs result in superior subjective satisfaction in SSV and improved ROM in all planes compared to the traditional distalized-medialized implant designs. In all three groups, no implant related complications were noted.</p>

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Clinical and radiological comparison of three different reverse shoulder arthroplasty designs for patients with primary osteoarthritis

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  • 发表日期：

    2025年6月14日

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  • Jan-Philipp Imiolczyk,
  • Laurent Audigé,
  • Florian Freislederer,
  • Tim Schneller,
  • Yacine Ameziane,
  • Amadeo Touet,
  • Markus Scheibel

摘要

Aims

In reverse shoulder arthroplasty (RSA), different implant designs range from medializing implants to strongly lateralizing onlay designs with different neck-shaft-angles (NSA). Thus different degrees of lateralization are currently used. Aim of this study was to compare clinical and radiological outcomes of three different implant designs in a homogeneous patient cohort with primary osteoarthritis (OA).

Methods

Patients with OA who underwent RSA between 03/2014 and 01/2020 were included and categorized into three groups based on RSA design: group MD (medialized-distalized design: eccentric glenosphere, 155° NSA), group L (lateralized design: + 4 mm centric glenosphere, 135° NSA), group LD (lateralized-distalized design: eccentric glenospheres, + 3 mm baseplate, curved onlay stem 145° NSA). Inclusion criteria were complete clinical and radiological 24 months follow-up (FU) including range of motion (ROM), Constant-Murley score (CS), Subjective Shoulder Value (SSV). In addition, scapular notching and adverse events were recorded.

Results

Group MD including 26 patients (81% female; mean age: 77.9 years) reached 71 (range: 60–85) points in CS and 90% (range: 40–100) in SSV. In group L, 46 patients (98% female; mean age: 75.2 years) achieved a CS of 75 (59–85) points and SSV was 95% (60–100). In group LD, 25 patients (68% female; mean age: 76.3 years) presented a CS of 79 (30–100) points and SSV of 93% (50–100). Group L and group LD achieved significantly better abduction, internal and external rotation (p < 0.001), forward flexion (p = 0.023) and SSV (p = 0.046). Scapular notching was present in 22% of MD patients (13% grade 1; 4% grade 2; 4% grade 4), 16% in group L (all grade 1) and 9% in group LD (all grade 2). No prosthesis related complication occurred in any group.

Conclusion

In patients with primary OA, the lateralized and lateralized-distalized designs result in superior subjective satisfaction in SSV and improved ROM in all planes compared to the traditional distalized-medialized implant designs. In all three groups, no implant related complications were noted.