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Optimal glenoid component inclination in reverse shoulder arthroplasty. How to improve implant stability

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Abstract

Purpose

The purpose of this study is to demonstrate that inferior inclination of the glenosphere is a protecting factor from joint dislocation in reverse total shoulder replacement. The hypothesis is that an average of 10° of inferior inclination of the glenoid component would determine a significant inferior rate of dislocation as compared to neutral inclination.

Methods

A retrospective case (dislocation)–control (stability of the implant) study was performed. Inclusion criteria were the homogeneity of the prosthetic model and availability of pre- and postoperative imaging of the shoulder, including antero-posterior and axillary X-ray views. Glenoid and glenosphere inclination were calculated according to standardized methods. Difference in between the angles determined the inferior tilt.

Results

Thirty-three cases fit the inclusion criteria. Glenoid and glenosphere inclination measured, respectively, 74.1° and 83.5°. The average tilt of the glenosphere measured 9.4°. The average tilt in stable patients was 10.2°. Tilt in patients with atraumatic dislocation measured, respectively, −6.9° (superior tilt) and 2.4°, while it was 8.3° for the patient with traumatic instability. The association between the tilt of glenosphere and atraumatic dislocation was significant.

Conclusions

A 10° inferior tilt of the glenoid component in reverse shoulder arthroplasty is associated with a reduced risk of dislocation when compared to neutral tilt.

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Conflict of interest

Pietro Randelli, Filippo Randelli, Paolo Arrigoni, Vincenza Ragone, Riccardo D’Ambrosi, Pamela Masuzzo, Paolo Cabitza, Giuseppe Banfi declare that they have no conflict of interest.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revise in 2000 (5). All patients provided written informed consent to enrollment in the study and to the inclusion in this article of information that could potentially lead to their identification.

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Authors and Affiliations

  1. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy

    P. Randelli, P. Cabitza & G. Banfi

  2. IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Milan, Italy

    P. Randelli, F. Randelli, P. Arrigoni, V. Ragone, R. D’Ambrosi, P. Masuzzo & P. Cabitza

  3. IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

    G. Banfi

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  1. P. Randelli
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  2. F. Randelli
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  7. P. Cabitza
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Correspondence to P. Randelli.

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Randelli, P., Randelli, F., Arrigoni, P. et al. Optimal glenoid component inclination in reverse shoulder arthroplasty. How to improve implant stability. Musculoskelet Surg 98 (Suppl 1), 15–18 (2014). https://doi.org/10.1007/s12306-014-0324-1

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  • DOI: https://doi.org/10.1007/s12306-014-0324-1

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