Avoiding scapular notching in reverse total shoulder - a cadaver study

Evaluation of the role of glenosphere design and humeral component retroversion in avoiding scapular notching during reverse shoulder arthroplasty.

These authors implanted in 40 cadaver shoulders the Aequalis Reversed Shoulder Prosthesis (shown below in a photo from the website).

(Note the proximity of the upper medial aspect of the humeral component to the site of notching on the scapula). 

They used 8 different glenoid combinations: * 36-mm glenosphere: centered (standard), eccentric, with an inferior tilt, or with the center of rotation lateralized by 5 or 7 mm; and * 42-mm centered glenosphere: used alone or with the COR lateralized by 7 or 10 mm. The humeral component was positioned in 0, 10, 20, 30, and 40 of retroversion. 

Lateralization of the glenosphere and larger glenosphere diameters of curvature resulted in less risk of unwanted contact with the scapula. Retroversion of the humeral component also reduced the risk of unwanted contact with the scapula.

We use a glenosphere that has built in lateral displacement to avoid unwanted contact of the humeral component with the glenoid, which can result in both notching and instability. Our approach is shown here.
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