JSES published "Inferior tilt of the glenoid component does not decrease scapular notching in reverse shoulder arthroplasty: results of a prospective randomized study." This was a nicely randomized series that showed no effect of inferior glenoid tilt on the rate or severity of notching of the lateral scapular border. These results are consistent with those discussed in a previous post. The prosthesis used in this study (Aequalis/Tornier) does not have an offset of the center of the glenosphere from the glenoid bone, so that the center of rotation is on the glenoid bone face. As a result the humeral component may contact the lateral scapular border when the arm is adducted.
It is concerning to note that at 1 year after surgery notching was noted in 34 of 42 shoulders. Because notching is accompanied by bone loss and polyethylene wear, it may be worthwhile considering a reverse total shoulder technique that offsets the glenoid center from the glenoid bone.
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