Can a functional difference be detected in reverse arthroplasty with 135versus 155prosthesis for the treatment of rotator cuff arthropathy: a prospective randomized study
The Anthrex Univers Revers has an adaptable inlay humeral cup that can be locked at either 135 or 155 degrees.
These authors conducted a randomized controlled trail comparing outcomes with these two inclinations in 100 patients undergoing primary reverse shoulder arthroplasty (RSA). The prostheses were otherwise identical. A neutral glenosphere was used in all cases.
There was no difference in range of motion or functional outcome scores between the 2 groups.
Scapular notching was observed in 58% of cases with a 155 degree inclination compared with 21% with a 135 degree inclination.
Based on these observations, these authors now use a lateralized glenosphere with a 135 degree prosthesis.
Comment: While originally dismissed as having no clinical significance, it is now recognized that scapular notching is associated with inferior long term results from reverse total shoulder arthroplasty. We concur that a lateralized glenosphere can reduce the risk of notching as shown below.
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