Accuracy of placement of the glenoid component in reverse shoulder arthroplasty using a custom baseplate for severe glenoid deficiency

Abstract

Background: Glenoid bone deficiency can lead to early component loosening and implant failure during reverse total shoulder arthroplasty (rTSA). Recently, the glenoid Vault Reconstruction System (Zimmer-Biomet, Warsaw, IN, USA), a computer-aided design ot computer-assisted manufacturing system, was developed, with good clinical outcomes, including no radiographic loosening. This study examined the postoperative accuracy of glenoid component placement using this system at three different facilities. Methods: Nine patients undergoing rTSA with vault reconstruction system performed by three board-certified, fellowship-trained shoulder surgeons at three different institutions between August 2020 and January 2023 were included. Preoperative and postoperative computed tomography was performed, and glenoid inclination and version were measured using a postoperative three-dimensional evaluation system. Surgical time and intraoperative blood loss were also measured. Results: The range of errors of glenoid inclination and version were 3.5 ± 2.5° (0.4–8.3) and 3.2 ± 2.2° (0.4–6.7), respectively. In primary cases, the error ranges of both glenoid inclination and version were within 5° in six of seven cases (85.7%). In revision cases, both glenoid inclination and version were within 10°. The mean operative time was 131.4 ± 48.9 (80–206) min and the mean intraoperative blood loss was 161.1 ± 94.2 (30–300) ml; there were no intraoperative complications. Conclusion: In the present study, the placement position was good in primary and revision cases, making the placement of the glenoid component of the rTSA using vault reconstruction system in cases of glenoid bone deficiency highly reproducible.

Keywords

• Level IV
• Case Series
• Treatment Study