BACKGROUND: Reverse shoulder arthroplasty (RSA) has revolutionized the management of many shoulder pathologies. Lateralization has become favourable to combat complications (e.g. notching, compromised external rotation), using a metallic, or autogenous bone-graft baseplates - bony increased-offset reverse shoulder arthroplasty (BIO-RSA). We systematically reviewed the literature to determine: Does BIO-RSA improve range of motion and outcome scores?Are notching rates decreased?Does the graft heal? METHODS: All available prospective studies, trials and case series reporting on BIO-RSA were included. Outcomes were grouped into outcome scores, range of motion and radiographic outcomes. Data were pooled and statistical analysis performed. RESULTS: Eight studies reported on 385 RSA - 235 BIO-RSA and 150 standard-RSA (STD-RSA). Follow-up was 20-36 months; average age 74 years. Outcome scores: Constant-Murley and SSV scores showed statistically significant post-operative benefit of BIO-RSA (mean-difference 4.0 (95% confidence interval (CI): 0.79,7.1) and 6.8 (95% CI: 3.8, 9.9)). No Minimal Clinically Importance Difference was surpassed. Range of motion: No difference was found in any direction. Notching: Notching was less likely with BIO-RSA (odds ratio 0.19 (95% CI: 0.10, 0.38)). Healing and loosening: 92% grafts fully healed/incorporated. Loosening rate was 2.4%. CONCLUSIONS: Literature on BIO-RSA is limited with only one randomised controlled trial (RCT). Weak evidence exists for improved outcome scores. Range of motion is equivocal. Notching rates are significantly lower in BIO-RSA. The graft usually heals.
BACKGROUND: Reverse shoulder arthroplasty (RSA) has revolutionized the management of many shoulder pathologies. Lateralization has become favourable to combat complications (e.g. notching, compromised external rotation), using a metallic, or autogenous bone-graft baseplates - bony increased-offset reverse shoulder arthroplasty (BIO-RSA). We systematically reviewed the literature to determine: Does BIO-RSA improve range of motion and outcome scores?Are notching rates decreased?Does the graft heal? METHODS: All available prospective studies, trials and case series reporting on BIO-RSA were included. Outcomes were grouped into outcome scores, range of motion and radiographic outcomes. Data were pooled and statistical analysis performed. RESULTS: Eight studies reported on 385 RSA - 235 BIO-RSA and 150 standard-RSA (STD-RSA). Follow-up was 20-36 months; average age 74 years. Outcome scores: Constant-Murley and SSV scores showed statistically significant post-operative benefit of BIO-RSA (mean-difference 4.0 (95% confidence interval (CI): 0.79,7.1) and 6.8 (95% CI: 3.8, 9.9)). No Minimal Clinically Importance Difference was surpassed. Range of motion: No difference was found in any direction. Notching: Notching was less likely with BIO-RSA (odds ratio 0.19 (95% CI: 0.10, 0.38)). Healing and loosening: 92% grafts fully healed/incorporated. Loosening rate was 2.4%. CONCLUSIONS: Literature on BIO-RSA is limited with only one randomised controlled trial (RCT). Weak evidence exists for improved outcome scores. Range of motion is equivocal. Notching rates are significantly lower in BIO-RSA. The graft usually heals.
Authors: George S Athwal; Joy C MacDermid; K Murali Reddy; Jonathan P Marsh; Kenneth J Faber; Darren Drosdowech Journal: J Shoulder Elbow Surg Date: 2014-10-22 Impact factor: 3.019
Authors: Alexandre Lädermann; Boyko Gueorguiev; Caecilia Charbonnier; Bojan V Stimec; Jean H D Fasel; Ivan Zderic; Jennifer Hagen; Gilles Walch Journal: Medicine (Baltimore) Date: 2015-09 Impact factor: 1.817
Authors: Julia K Frank; Paul Siegert; Fabian Plachel; Philipp R Heuberer; Stephanie Huber; Jakob E Schanda Journal: J Clin Med Date: 2022-03-10 Impact factor: 4.241