In revision to reverse shoulder arthroplasty (RSA), improper correction of glenoid deformity can result in over-medialization, baseplate fixation compromise, or variation in baseplate inclination or version. This study assessed clinical and radiographic outcomes of a non-custom augmented baseplate in the setting of revision to RSA.
Methods
This was a retrospective cohort study of patients who underwent revision to RSA (from a prior shoulder arthroplasty procedure) with an augmented baseplate with a minimum 2-year follow-up. Radiographic and clinical outcomes were assessed.
Results
Revision to RSA with a baseplate augment was performed in 25 patients (age 68.2 ± 8.9 years). There was improvement in elevation (98 to 146, p < 0.001), external rotation (28 to 39, p = 0.032), American Shoulder and Elbow Surgeon score (36.5 to 75.4, p < 0.001), Single Alpha Numeric Evaluation score (30.1 to 70.0, p < 0.001), and Visual Analog Pain Score (6.2 to 2.3, p < 0.001). One patient had radiographic evidence of baseplate mechanical failure (4%), two cases had postoperative instability (8%), and two cases had periprosthetic humerus fractures (8%).
Discussion
In the setting of glenoid bone loss and revision to RSA, baseplate full and half-wedge “off-the-shelf” augments provide favorable short-term outcomes with a low rate of baseplate failure (4%) at a mean 2.7-year follow-up.
ContrerasESKingeryMTZuckermanJD, et al.Treatment of glenoid wear with the use of augmented glenoid components in total shoulder arthroplasty: a scoping review. JBJS Rev2023; 11: e23.00063.
2.
KnowlesNKColumbusMPWegmannK, et al.Revision shoulder arthroplasty: a systematic review and comparison of North American vs. European outcomes and complications. J Shoulder Elbow Surg2020; 29: 1071–1082.
3.
MalahiasMAChytasDKostretzisL, et al.Bone grafting in primary and revision reverse total shoulder arthroplasty for the management of glenoid bone loss: a systematic review. J Orthop2020; 20: 78–86.
4.
OlsonJJGrangerCJHillJR, et al.Revision of failed reverse total shoulder arthroplasty with reverse: short-term clinical outcomes. J Shoulder Elbow Surg2024; 33: 908–915.
5.
ShethMSholderDPadegimasEM, et al.Failure of anatomic total shoulder arthroplasty with revision to another anatomic total shoulder arthroplasty. Arch Bone Jt Surg2019; 7: 19–23.
6.
MouradWWiaterJMWiaterBP, et al.Baseplate options for reverse total shoulder arthroplasty. Curr Rev Musculoskelet Med2020; 13: 769–775.
7.
AbdicSKnowlesNKWalchG, et al.Type E2 glenoid bone loss orientation and management with augmented implants. J Shoulder Elbow Surg2020; 29: 1460–1469.
8.
BodendorferBMLoughranGJLooneyAM, et al.Short-term outcomes of reverse shoulder arthroplasty using a custom baseplate for severe glenoid deficiency. J Shoulder Elbow Surg2021; 30: 1060–1067.
9.
BoileauPMorin-SalvoNBessiereC, et al.Bony increased-offset-reverse shoulder arthroplasty: 5 to 10 years’ follow-up. J Shoulder Elbow Surg2020; 29: 2111–2122.
10.
BoileauPMorin-SalvoNGauciMO, et al.Angled BIO-RSA (bony-increased offset-reverse shoulder arthroplasty): a solution for the management of glenoid bone loss and erosion. J Shoulder Elbow Surg2017; 26: 2133–2142.
11.
KirschJMPatelMSinghA, et al.Early clinical and radiographic outcomes of an augmented baseplate in reverse shoulder arthroplasty for glenohumeral arthritis with glenoid deformity. J Shoulder Elbow Surg2021; 30: S123–S130.
12.
LiuzzaLMaiDHGreyS, et al.Reverse total shoulder arthroplasty with a superior augmented glenoid component for Favard Type-E1, E2, and E3 glenoids. J Bone Joint Surg Am2020; 102: 1865–1873.
13.
WagnerEHoudekMTElhassanBT, et al.Glenoid bone-grafting in revision to a reverse total shoulder arthroplasty: surgical technique. JBJS Essent Surg Tech2016; 6: 35.
14.
WagnerEHoudekMTGriffithT, et al.Glenoid bone-grafting in revision to a reverse total shoulder arthroplasty. J Bone Joint Surg Am2015; 97: 1653–1660.
15.
LorenzettiAStreitJJCabezasAF, et al.Bone graft augmentation for severe glenoid bone loss in primary reverse total shoulder arthroplasty: outcomes and evaluation of host bone contact by 2D-3D image registration. JB JS Open Access2017; 2: e0015.
16.
HoJCThakarOChanWW, et al.Early radiographic failure of reverse total shoulder arthroplasty with structural bone graft for glenoid bone loss. J Shoulder Elbow Surg2020; 29: 550–560.
17.
TashjianRZBroschinskyKStertzI, et al.Structural glenoid allograft reconstruction during reverse total shoulder arthroplasty. J Shoulder Elbow Surg2020; 29: 534–540.
18.
LanhamNSPetersonJRAhmedR, et al.Comparison of glenoid bone grafting vs. augmented glenoid baseplates in reverse shoulder arthroplasty: a systematic review. J Shoulder Elbow Surg2023; 32: 885–891.
19.
LoEYWittAOusephA, et al.Comparison of early and late aseptic baseplate failure in primary reverse shoulder arthroplasty with and without structural glenoid autograft. J Shoulder Elbow Surg2025; 34: 820–827.
20.
Van de KleutMLYuanXTeeterMG, et al.Bony increased-offset reverse shoulder arthroplasty vs. metal augments in reverse shoulder arthroplasty: a prospective, randomized clinical trial with 2-year follow-up. J Shoulder Elbow Surg2022; 31: 591–600.
21.
RangarajanRBloutCKPatelVV, et al.Early results of reverse total shoulder arthroplasty using a patient-matched glenoid implant for severe glenoid bone deficiency. J Shoulder Elbow Surg2020; 29: S139–S148.
22.
DebeerPBerghsBPouliartN, et al.Treatment of severe glenoid deficiencies in reverse shoulder arthroplasty: the Glenius glenoid reconstruction system experience. J Shoulder Elbow Surg2019; 28: 1601–1608.
23.
OrtmaierRWiererGGruberMS. Functional and radiological outcomes after treatment with custom-made glenoid components in revision reverse shoulder arthroplasty. J Clin Med2022; 11: 551.
24.
PorcelliniGMicheloniGMTaralloL, et al.Custom-made reverse shoulder arthroplasty for severe glenoid bone loss: review of the literature and our preliminary results. J Orthop Traumatol2021; 22: 2.
25.
GiroMEChoiJY. Revision reverse total shoulder arthroplasty using an augmented glenoid baseplate: a review of current glenoid baseplate options and a case report. The Guthrie Journal2024; 76: 30–36.
26.
BartelsDWMarigiESperlingJW, et al.Revision reverse shoulder arthroplasty for anatomical glenoid component loosening was not universally successful: a detailed analysis of 127 consecutive shoulders. J Bone Joint Surg Am2021; 103: 879–886.
27.
CohnMRKunzeKNPolceEM, et al.Establishing clinically significant outcome thresholds for the single assessment numeric evaluation 2 years following total shoulder arthroplasty. J Shoulder Elbow Surg2021; 30: e137–e146.
28.
YendluriAAlexanianALeeAC, et al.The variability of MCID, SCB, PASS, and MOI thresholds for PROMs in the reverse total shoulder arthroplasty literature: a systematic review. J Shoulder Elbow Surg2024; 33: 2320–2332.
29.
Avant-Garde Health, Codman Shoulder Society Value-Based Care Group, Khan AZ, et al. Revision shoulder arthroplasty: predictors of subsequent revision surgery and economic burden amongst Medicare beneficiaries. J Shoulder Elbow Surg2025; 34: 1120–1129.
30.
HeifnerJJKumarADWagnerER. Reverse shoulder arthroplasty used for revision of reverse shoulder arthroplasty: a systematic review. JSES Rev Rep Tech2021; 1: 329–334.
31.
O'KeefeDSHaoKATeurlingsTL, et al.Survivorship analysis of revision reverse total shoulder arthroplasty. J Shoulder Elbow Surg2023; 32: e343–e354.
32.
GhantaRBTsayELFeeleyB. Augmented baseplates in reverse shoulder arthroplasty: a systematic review of outcomes and complications. JSES Rev Rep Tech2023; 3: 37–43.
33.
LevinJMBokshanSRocheCP, et al.Reverse shoulder arthroplasty with and without baseplate wedge augmentation in the setting of glenoid deformity and rotator cuff deficiency-a multicenter investigation. J Shoulder Elbow Surg2022; 31: 2488–2496.
34.
MartinEJDuquinTREhrensbergerMT. Reverse total shoulder arthroplasty baseplate stability in superior bone loss with augmented implant. J Shoulder Elb Arthroplast2021; 5: 24715492211020689.
35.
FliegelBEDeBernardisDFordE, et al.Biologic graft augmentation for glenoid bone loss in conversion of failed anatomic to reverse shoulder arthroplasty: a systematic review. JSES Rev Rep Tech2023; 3: 44–48.
36.
KusinDJTeytelbaumDETeusinkMJ, et al.Outcomes of femoral head allograft for the management of glenoid bone defects in revision reverse shoulder arthroplasty: a case-controlled study. J Shoulder Elbow Surg2023; 32: S32–S38.
37.
MahylisJMPuzzitielloRNHoJC, et al.Comparison of radiographic and clinical outcomes of revision reverse total shoulder arthroplasty with structural versus nonstructural bone graft. J Shoulder Elbow Surg2019; 28: e1–e9.
