Effect of scapular notching on clinical outcomes after reverse total shoulder arthroplasty
Young Hoon Jang, Jeong Hyun Lee, Sae Hoon Kim
Abstract
AIMS: Scapular notching is thought to have an adverse effect on the outcome of reverse total shoulder arthroplasty (RTSA). However, the matter is still controversial. The aim of this study was to determine the clinical impact of scapular notching on outcomes after RTSA. METHODS: Three electronic databases (PubMed, Cochrane Database, and EMBASE) were searched for studies which evaluated the influence of scapular notching on clinical outcome after RTSA. The quality of each study was assessed. Functional outcome scores (the Constant-Murley scores (CMS), and the American Shoulder and Elbow Surgeons (ASES) scores), and postoperative range of movement (forward flexion (FF), abduction, and external rotation (ER)) were extracted and subjected to meta-analysis. Effect sizes were expressed as weighted mean differences (WMD). RESULTS: In all, 11 studies (two level III and nine level IV) were included in the meta-analysis. All analyzed variables indicated that scapular notching has a negative effect on the outcome of RTSA . Statistical significance was found for the CMS (WMD -3.11; 95% confidence interval (CI) -4.98 to -1.23), the ASES score (WMD -6.50; 95% CI -10.80 to -2.19), FF (WMD -6.3°; 95% CI -9.9° to -2.6°), and abduction (WMD -9.4°; 95% CI -17.8° to -1.0°), but not for ER (WMD -0.6°; 95% CI -3.7° to 2.5°). CONCLUSION: 2020;102-B(11):1438-1445.