Does glenoid baseplate geometry affect its fixation in reverse shoulder arthroplasty?

BACKGROUND

The effect of glenoid baseplate geometry has not been studied as it pertains to reverse shoulder arthroplasty. The purpose of this study was to compare 2 baseplate designs whose major difference is being either a flat backed design or a convex baseplate, with regard to their bone interface area, screw engagement, and bone volume removed using 3-dimensional modeling.

METHODS

Three-dimensional models of 6 scapulae were used to virtually implant models of a flat backed and a convex backed glenoid baseplate. Additional reaming was performed in 1 mm increments, up to 5 mm, and the amount of baseplate screw engagement was calculated at each increment. Statistical differences between flat and convex implants were calculated.

RESULTS

Insertion of the convex baseplate required statistically greater removal of bone as compared to the flat baseplate (P = .003). No statistical changes in total area were observed with reaming of the glenoid for the convex baseplate (P > .095). However, for the flat baseplate, 1 mm of reaming caused a statistical decrease in area available for fixation. The amount of total bone area in contact with a convex baseplate was statistically greater than with a flat baseplate (P = .004). The amount of screw engagement was statistically less with the convex baseplate, compared to the flat (P = .026).

DISCUSSION

A convex backed glenoid baseplate can improve the contact surface area at the bone implant interface as compared to a flat backed design. However, better screw engagement and less bone volume removed during reaming favors a flat backed design, particularly when adequate bone-implant contact cannot be achieved.