Parker Simon J M, Bell Simon N, Wiemer Féoline, Coghlan Jennifer A, Clitherow Harry D, Rayment Helen M
Melbourne Shoulder and Elbow Centre, Brighton , Victoria, Australia.
Department of Surgery (School of Clinical Sciences at Monash Health), Monash University, Clayton, Victoria, Australia.
Shoulder Elbow. 2024 Nov 21:17585732241293396. doi: 10.1177/17585732241293396.
Avoiding inclination of the glenoid baseplate in reverse shoulder arthroplasty often requires considerable glenoid reaming. It is proposed that the use of a metal wedged baseplate in all patients can achieve neutral inclination with reduced glenoid reaming.
A prospective clinical single-centre study with minimum two-year follow-up was carried out. Glenoid deformity was classified on CT and surgery planned using BluePrint. The Tornier Perform Reversed Wedged Augmented Glenoid was used in all cases. Clinical outcome scores and radiographs were assessed.
Seventy-three patients, mean age 76.6 years. Twenty-eight demonstrated no glenoid deformity and 19 demonstrated marked retroversion. Seventy completed two-year follow-up. Mean pain scores fell from 6 to 0.7. All Patient Reported Outcome Meaures (PROMS) were significantly improved. Active elevation increased by 62° and external rotation by 28.7° ( < 0.001). In patients with no glenoid wear (E0/A1), correction of inferior inclination was achievable with a 15° full-wedge baseplate in all cases, reducing the reaming depth by 4.4 mm ( < 0.001). In patients with severe glenoid wear, a 35° half wedge baseplate was often necessary to correct the deformity. The most common complications were stress reactions/fractures.
A metal wedged baseplate can achieve neutral inclination in all patients, minimising bone reaming and preserving lateralisation with good two-year outcomes.
IV (case series with no comparison group).
在反肩关节置换术中避免肩胛盂基板倾斜通常需要进行大量的肩胛盂扩孔。有人提出，在所有患者中使用金属楔形基板可以在减少肩胛盂扩孔的情况下实现中立倾斜。
进行了一项前瞻性临床单中心研究，随访至少两年。通过CT对肩胛盂畸形进行分类，并使用BluePrint计划手术。所有病例均使用Tornier Perform反向楔形增强肩胛盂。评估临床结果评分和X线片。
73例患者，平均年龄76.6岁。28例无肩胛盂畸形，19例有明显的后倾。70例完成了两年随访。平均疼痛评分从6分降至0.7分。所有患者报告结局指标（PROMS）均有显著改善。主动抬高增加62°，外旋增加28.7°（P<0.001）。在无肩胛盂磨损的患者（E0/A1）中，所有病例使用15°全楔形基板均可实现下倾矫正，扩孔深度减少4.4 mm（P<0.001）。在肩胛盂严重磨损的患者中，通常需要35°半楔形基板来矫正畸形。最常见的并发症是应力反应/骨折。
金属楔形基板可使所有患者实现中立倾斜，减少骨扩孔并保持外展，两年疗效良好。
IV（无比较组的病例系列）。
