Does glenoid retroversion matter in reverse total shoulder?

Substantial amounts of time and money are spent in assessing and addressing glenoid retroversion in shoulders having reverse total shoulder arthroplasty. Some authors suggest that failure to restore glenoid component version to ‘‘normal’’ values may lead to suboptimal joint biomechanics and subsequent component failure. This concern has given rise to the use of 3D CT preoperative planning, eccentric reaming of the glenoid bone, bone grafts and augmented baseplates to reduce postoperative glenoid retroversion to 15 degrees or less.

The authors of Baseplate retroversion does not affect postoperative outcomes after reverse shoulder arthroplasty

investigated the relevance of postoperative glenoid version to the functional outcomes, range of motion, and postoperative complications in 271 patients having a 77% 2-year follow-up rate. 

161 patients had postoperative retroversion less than or equal to 15 degrees, and 110 patients had retroversion greater than 15 degrees. 

There were no significant differences between the groups with respect to American Shoulder and Elbow Surgeons scores, visual analog scales, Single Assessment Numeric Evaluation scores, postoperative range of motion, or complication rates.

The authors state that preserving glenoid bone stock may be more important than aiming for a specific degree of glenoid retroversion in reverse total shoulder arthroplasty.

Comment: These results suggest that preoperative 3D CT planning to guide glenoid retroversion, augmented baseplate implants, or bone grafts are not needed for most cases of reverse total shoulder arthroplasty.

Similar concerns can be raised regarding version in anatomic shoulder arthroplasty as discussed in this post:

Arthritic glenoid retroversion: what to do about it, is an augmented glenoid of value?

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Here are some videos that are of shoulder interest

Shoulder arthritis - what you need to know (see this link).

How to x-ray the shoulder (see this link).

The ream and run procedure (see this link).

The total shoulder arthroplasty (see this link).

The cuff tear arthropathy arthroplasty (see this link).

The reverse total shoulder arthroplasty (see this link).

The smooth and move procedure for irreparable rotator cuff tears (see this link).

Shoulder rehabilitation exercises (see this link).