Sunday, September 12, 2021

Reverse total shoulder with a hybrid baseplate - does this innovation add value for the patient?

 Clinical and radiographic outcomes of reverse shoulder arthroplasty using a hybrid baseplate fixation mechanism

These authors retrospectively analyzed the records of 142 patients (142 shoulders) who  underwent primary reverse total shoulder (RSA) using a hybrid baseplate designed by the senior surgeons.

Their goal was to test the hypothesis "that the hybrid baseplate grants comparable functional and clinical scores to those reported for other baseplates". In other words, they did not set out to show that this innovation was of greater value than the implants in current use.

119 patients were included in the final analysis (71 women (60%), and 48 men (40%), aged 73.6±7.3 years at index surgery).  43 of the procedures included a bony increased offset (BIO) (36%). 

They found a revision rate of 5.3%, which included 4 cases of glenoid loosening, three cases of deep infection and one case of instability. All four cases of glenoid loosening had been performed with BIO- RSA that had been implanted with superior orientation.

They concluded that at a minimum follow-up of 2 years following RSA using a new hybrid baseplate system, the Constant scores and range of motion were comparable to those in recent systematic reviews: 

Lateralized versus nonlateralized glenospheres in reverse shoulder arthroplasty: a systematic review with meta-analysis and Reverse total shoulder arthroplasty clinical and patient-reported outcomes and complications stratified by preoperative diagnosis: a systematic review.

Comment: In the absence of data that this baseplate is less costly than others in current use, the evidence does not demonstrate that this innovation adds value for patients having reverse total shoulder (see this link).

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Here are some videos that are of shoulder interest
Shoulder arthritis - what you need to know (see this link)
The smooth and move for irreparable cuff tears (see this link)
The total shoulder arthroplasty (see this link).
The ream and run technique is shown in this link.
The cuff tear arthropathy arthroplasty (see this link).
The reverse total shoulder arthroplasty (see this link).

Shoulder rehabilitation exercises (see this link).