Reverse Shoulder Arthroplasty with Bony and Metallic versus Standard Bony Reconstruction for Severe Glenoid Bone Loss. A Retrospective Comparative Cohort Study

There are different techniques to address severe glenoid erosion during reverse shoulder arthroplasty (RSA). This study assessed the clinical and radiological outcomes of RSA with combined bony and metallic augment (BMA) glenoid reconstruction compared to bony augmentation (BA) alone. A review of pa...

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Autores principales:	Marko Nabergoj, Lionel Neyton, Hugo Bothorel, Sean W. L. Ho, Sidi Wang, Xue Ling Chong, Alexandre Lädermann
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	shoulder prosthesis defect reconstruction autologous graft survivorship Medicine R
Acceso en línea:	https://doaj.org/article/a63d728ed7cc4ed998de2e17cc6ee1ee
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spelling	oai:doaj.org-article:a63d728ed7cc4ed998de2e17cc6ee1ee2021-11-25T18:01:12ZReverse Shoulder Arthroplasty with Bony and Metallic versus Standard Bony Reconstruction for Severe Glenoid Bone Loss. A Retrospective Comparative Cohort Study10.3390/jcm102252742077-0383https://doaj.org/article/a63d728ed7cc4ed998de2e17cc6ee1ee2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5274https://doaj.org/toc/2077-0383There are different techniques to address severe glenoid erosion during reverse shoulder arthroplasty (RSA). This study assessed the clinical and radiological outcomes of RSA with combined bony and metallic augment (BMA) glenoid reconstruction compared to bony augmentation (BA) alone. A review of patients who underwent RSA with severe glenoid bone loss requiring reconstruction from January 2017 to January 2019 was performed. Patients were divided into two groups: BMA versus BA alone. Clinical outcome measurements included two years postoperative ROM, Constant score, subjective shoulder value (SSV), and the American Shoulder and Elbow Surgeons Shoulder (ASES) score. Radiological outcomes included radiographic evidence of scapular complications and graft incorporation. The BMA group had significantly different glenoid morphology (<i>p</i> < 0.001) and greater bone loss thickness than the BA group (16.3 ± 3.8 mm vs. 12.0 ± 0.0 mm, <i>p</i> = 0.020). Both groups had significantly improved ROM (anterior forward flexion and external rotation) and clinical scores (Constant, SSV and ASES scores) at 2 years. Greater improvement was observed in the BMA group in terms of anterior forward flexion (86.3° ± 27.9° vs. 43.8° ± 25.6°, <i>p</i> = 0.013) and Constant score (56.6 ± 10.1 vs. 38.3 ± 16.7, <i>p</i> = 0.021). The BA group demonstrated greater functional and clinical improvements with higher postoperative active external rotation and ASES results (active external rotation, 49.4° ± 17.0° vs. 29.4° ± 14.7°, <i>p</i> = 0.017; ASES, 89.1 ± 11.3 vs. 76.8 ± 11.0, <i>p</i> = 0.045). The combination use of bone graft and metallic augments in severe glenoid bone loss during RSA is safe and effective and can be considered in cases of severe glenoid bone loss where bone graft alone may be insufficient.Marko NabergojLionel NeytonHugo BothorelSean W. L. HoSidi WangXue Ling ChongAlexandre LädermannMDPI AGarticleshoulderprosthesisdefectreconstructionautologous graftsurvivorshipMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5274, p 5274 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	shoulder prosthesis defect reconstruction autologous graft survivorship Medicine R
spellingShingle	shoulder prosthesis defect reconstruction autologous graft survivorship Medicine R Marko Nabergoj Lionel Neyton Hugo Bothorel Sean W. L. Ho Sidi Wang Xue Ling Chong Alexandre Lädermann Reverse Shoulder Arthroplasty with Bony and Metallic versus Standard Bony Reconstruction for Severe Glenoid Bone Loss. A Retrospective Comparative Cohort Study
description	There are different techniques to address severe glenoid erosion during reverse shoulder arthroplasty (RSA). This study assessed the clinical and radiological outcomes of RSA with combined bony and metallic augment (BMA) glenoid reconstruction compared to bony augmentation (BA) alone. A review of patients who underwent RSA with severe glenoid bone loss requiring reconstruction from January 2017 to January 2019 was performed. Patients were divided into two groups: BMA versus BA alone. Clinical outcome measurements included two years postoperative ROM, Constant score, subjective shoulder value (SSV), and the American Shoulder and Elbow Surgeons Shoulder (ASES) score. Radiological outcomes included radiographic evidence of scapular complications and graft incorporation. The BMA group had significantly different glenoid morphology (<i>p</i> < 0.001) and greater bone loss thickness than the BA group (16.3 ± 3.8 mm vs. 12.0 ± 0.0 mm, <i>p</i> = 0.020). Both groups had significantly improved ROM (anterior forward flexion and external rotation) and clinical scores (Constant, SSV and ASES scores) at 2 years. Greater improvement was observed in the BMA group in terms of anterior forward flexion (86.3° ± 27.9° vs. 43.8° ± 25.6°, <i>p</i> = 0.013) and Constant score (56.6 ± 10.1 vs. 38.3 ± 16.7, <i>p</i> = 0.021). The BA group demonstrated greater functional and clinical improvements with higher postoperative active external rotation and ASES results (active external rotation, 49.4° ± 17.0° vs. 29.4° ± 14.7°, <i>p</i> = 0.017; ASES, 89.1 ± 11.3 vs. 76.8 ± 11.0, <i>p</i> = 0.045). The combination use of bone graft and metallic augments in severe glenoid bone loss during RSA is safe and effective and can be considered in cases of severe glenoid bone loss where bone graft alone may be insufficient.
format	article
author	Marko Nabergoj Lionel Neyton Hugo Bothorel Sean W. L. Ho Sidi Wang Xue Ling Chong Alexandre Lädermann
author_facet	Marko Nabergoj Lionel Neyton Hugo Bothorel Sean W. L. Ho Sidi Wang Xue Ling Chong Alexandre Lädermann
author_sort	Marko Nabergoj
title	Reverse Shoulder Arthroplasty with Bony and Metallic versus Standard Bony Reconstruction for Severe Glenoid Bone Loss. A Retrospective Comparative Cohort Study
title_short	Reverse Shoulder Arthroplasty with Bony and Metallic versus Standard Bony Reconstruction for Severe Glenoid Bone Loss. A Retrospective Comparative Cohort Study
title_full	Reverse Shoulder Arthroplasty with Bony and Metallic versus Standard Bony Reconstruction for Severe Glenoid Bone Loss. A Retrospective Comparative Cohort Study
title_fullStr	Reverse Shoulder Arthroplasty with Bony and Metallic versus Standard Bony Reconstruction for Severe Glenoid Bone Loss. A Retrospective Comparative Cohort Study
title_full_unstemmed	Reverse Shoulder Arthroplasty with Bony and Metallic versus Standard Bony Reconstruction for Severe Glenoid Bone Loss. A Retrospective Comparative Cohort Study
title_sort	reverse shoulder arthroplasty with bony and metallic versus standard bony reconstruction for severe glenoid bone loss. a retrospective comparative cohort study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/a63d728ed7cc4ed998de2e17cc6ee1ee
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Reverse Shoulder Arthroplasty with Bony and Metallic versus Standard Bony Reconstruction for Severe Glenoid Bone Loss. A Retrospective Comparative Cohort Study

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