Augmented baseplates in reverse shoulder arthroplasty: a systematic review of outcomes and complications

Abstract

BackgroundGlenoid wear secondary to primary osteoarthritis or rotator cuff arthropathy is an obstacle commonly encountered by surgeons performing reverse shoulder arthroplasty, with numerous techniques devised to address this finding. The most recent of such techniques is the introduction of augmented glenoid baseplates to fill these glenoid defects. The objectives of this systematic review are to analyze clinical outcomes of augmented baseplates in patients with glenoid wear, including pain, range of motion, patient-reported functional scores, radiographic outcome measures, complication rates, and revision rates.MethodsThree online databases (Ovid Medline, EMBASE, Pubmed) were searched for studies publishing clinical and functional outcomes of augmented baseplates in primary reverse shoulder arthroplasty. Findings were aggregated and frequency-weighted means of these variables were calculated when applicable.ResultsSeven studies comprising 810 patients were included in this review. The mean patient age was 72.1 ± 8.1 years with an average follow-up time of 41.4 months. Frequency-weighted means of improvement in forward elevation, abduction, and active external rotation were 53°, 47°, and 19°, respectively. Patients experienced American Shoulder and Elbow Surgeons, Simple Shoulder Test, and Constant score improvements of 45.9, 5.9, and 33.7, respectively. Pooled complicated rate was 6.4%, with 10 cases of baseplate loosening and 3 cases of instability. Five (0.6%) patients required reoperation. Subdividing among augment type (posterior, superior, posterosuperior), there were no apparent differences in outcomes or complication rates between directional augments.ConclusionThis systematic review demonstrates that augmented baseplates for reverse shoulder arthroplasty provide positive outcomes both clinically and functionally at early follow-up. Complications are within an acceptable range for primary reverse shoulder arthroplasty, with a low rate of revision. Augmented baseplates should serve as a viable option for surgeons seeking to address glenoid wear during reverse shoulder arthroplasty. Glenoid wear secondary to primary osteoarthritis or rotator cuff arthropathy is an obstacle commonly encountered by surgeons performing reverse shoulder arthroplasty, with numerous techniques devised to address this finding. The most recent of such techniques is the introduction of augmented glenoid baseplates to fill these glenoid defects. The objectives of this systematic review are to analyze clinical outcomes of augmented baseplates in patients with glenoid wear, including pain, range of motion, patient-reported functional scores, radiographic outcome measures, complication rates, and revision rates. Three online databases (Ovid Medline, EMBASE, Pubmed) were searched for studies publishing clinical and functional outcomes of augmented baseplates in primary reverse shoulder arthroplasty. Findings were aggregated and frequency-weighted means of these variables were calculated when applicable. Seven studies comprising 810 patients were included in this review. The mean patient age was 72.1 ± 8.1 years with an average follow-up time of 41.4 months. Frequency-weighted means of improvement in forward elevation, abduction, and active external rotation were 53°, 47°, and 19°, respectively. Patients experienced American Shoulder and Elbow Surgeons, Simple Shoulder Test, and Constant score improvements of 45.9, 5.9, and 33.7, respectively. Pooled complicated rate was 6.4%, with 10 cases of baseplate loosening and 3 cases of instability. Five (0.6%) patients required reoperation. Subdividing among augment type (posterior, superior, posterosuperior), there were no apparent differences in outcomes or complication rates between directional augments. This systematic review demonstrates that augmented baseplates for reverse shoulder arthroplasty provide positive outcomes both clinically and functionally at early follow-up. Complications are within an acceptable range for primary reverse shoulder arthroplasty, with a low rate of revision. Augmented baseplates should serve as a viable option for surgeons seeking to address glenoid wear during reverse shoulder arthroplasty.

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