PMID- 38492629
OWN - NLM
STAT- MEDLINE
DCOM- 20240516
LR  - 20240516
IS  - 1532-6500 (Electronic)
IS  - 1058-2746 (Linking)
VI  - 33
IP  - 6S
DP  - 2024 Jun
TI  - Primary and revision reverse total shoulder arthroplasty using a patient-matched 
      glenoid implant for severe glenoid bone deficiency.
PG  - S93-S103
LID - S1058-2746(24)00184-8 [pii]
LID - 10.1016/j.jse.2024.03.005 [doi]
AB  - BACKGROUND: Severe glenoid bone loss in the setting of both primary and revision 
      reverse total shoulder arthroplasty (rTSA) continues to remain a significant 
      challenge. The purpose of this study was to report on radiographic and clinical 
      outcomes of primary and revision rTSA using a patient-matched, 3-dimensionally 
      printed metal glenoid implant to address severe glenoid bone deficiency. This is 
      a follow-up study to previously reported preliminary results. METHODS: A 
      retrospective review was performed on 62 patients with severe glenoid bone 
      deficiency who underwent either primary or revision rTSA using the Comprehensive 
      Vault Reconstruction System (VRS) (Zimmer Biomet) at a single institution. 
      Preoperative and postoperative values for the Disabilities of the Arm, Shoulder 
      and Hand (DASH), Constant, American Shoulder and Elbow Surgeons Standardized 
      Shoulder Assessment Form (ASES), Simple Shoulder Test (SST), Single Assessment 
      Numeric Evaluation (SANE), and visual analog scale (VAS) pain scores as well as 
      active range of motion (ROM) were collected and compared using the Wilcoxon 
      signed rank test with the level of statistical significance set at P < .05. The 
      percentage of patients achieving minimal clinically important difference (MCID) 
      and substantial clinical benefit (SCB) was also calculated. RESULTS: Fifty-five 
      of 62 shoulders (88.7%) were able to be contacted at a minimum of 2 years 
      postoperatively, with 47 of 62 (75.8%) having complete clinical and radiographic 
      follow-up with a mean age of 67.5 years (range, 48-85 years) and follow-up of 
      39.2 months (range, 25-56 months). There were 19 primary and 28 revision rTSAs. 
      Significant improvements were seen in mean active forward flexion (63.1 degrees  +/- 30.3 degrees  
      to 116.8 degrees  +/- 35 degrees ), abduction (48.1 degrees  +/- 16.1 to 76.2 degrees  +/- 13.4 degrees ) (P < .001), external 
      rotation (16 degrees  +/- 23.7 degrees  to 32.1 degrees  +/- 24.5 degrees ) (P < .005), DASH (59.9 +/- 17.7 to 
      35.7 +/- 24.3), Constant (23.4 +/- 13.1 to 53.1 +/- 17.4), ASES (27.8 +/- 16.2 to 
      69.1 +/- 25.2), SST (3.3 +/- 2.5 to 7.6 +/- 3.5), SANE (28.9 +/- 18.3 to 66.7 +/- 21.2), 
      and VAS pain (7.1 +/- 2.4 to 1.8 +/- 2.6) scores (P < .001). MCID and SCB was 
      achieved in a majority of patients postoperatively. The overall complication rate 
      was 29.1%, with only 1 baseplate failure. CONCLUSION: This study demonstrates 
      promising evidence that the VRS implant can be used as a viable option to achieve 
      clinically important improvement in a majority of patients treated for severe 
      glenoid bone deficiency with rTSA in both the primary and revision setting.
CI  - Copyright (c) 2024 Journal of Shoulder and Elbow Surgery Board of Trustees. 
      Published by Elsevier Inc. All rights reserved.
FAU - Michelin, Richard M
AU  - Michelin RM
AD  - Cedars Sinai-Kerlan Jobe Institute, Los Angeles, CA, USA; White Memorial Medical 
      Center, Los Angeles, CA, USA; Crovetti Orthopaedics and Sports Medicine, Las 
      Vegas, NV, USA. Electronic address: michelinortho@gmail.com.
FAU - Manuputy, Isaac
AU  - Manuputy I
AD  - Cedars Sinai-Kerlan Jobe Institute, Los Angeles, CA, USA; White Memorial Medical 
      Center, Los Angeles, CA, USA.
FAU - Rangarajan, Rajesh
AU  - Rangarajan R
AD  - Cedars Sinai-Kerlan Jobe Institute, Los Angeles, CA, USA; White Memorial Medical 
      Center, Los Angeles, CA, USA.
FAU - Lee, Brian K
AU  - Lee BK
AD  - Cedars Sinai-Kerlan Jobe Institute, Los Angeles, CA, USA; White Memorial Medical 
      Center, Los Angeles, CA, USA.
FAU - Schultzel, Mark
AU  - Schultzel M
AD  - United Medical Doctors, San Diego, CA, USA.
FAU - Itamura, John M
AU  - Itamura JM
AD  - Cedars Sinai-Kerlan Jobe Institute, Los Angeles, CA, USA; White Memorial Medical 
      Center, Los Angeles, CA, USA.
LA  - eng
PT  - Journal Article
DEP - 20240315
PL  - United States
TA  - J Shoulder Elbow Surg
JT  - Journal of shoulder and elbow surgery
JID - 9206499
SB  - IM
MH  - Humans
MH  - *Arthroplasty, Replacement, Shoulder/methods
MH  - Retrospective Studies
MH  - Male
MH  - Female
MH  - Aged
MH  - *Reoperation/methods
MH  - Middle Aged
MH  - *Range of Motion, Articular
MH  - *Prosthesis Design
MH  - *Shoulder Joint/surgery/diagnostic imaging/physiopathology
MH  - *Shoulder Prosthesis
MH  - Aged, 80 and over
MH  - Treatment Outcome
MH  - Follow-Up Studies
OTO - NOTNLM
OT  - Glenoid bone loss
OT  - custom shoulder implant
OT  - glenoid deficiency
OT  - patient-matched glenoid implant
OT  - reverse total shoulder arthroplasty
OT  - shoulder arthroplasty
OT  - shoulder replacement
EDAT- 2024/03/17 00:42
MHDA- 2024/05/17 00:43
CRDT- 2024/03/16 20:25
PHST- 2023/11/26 00:00 [received]
PHST- 2024/03/10 00:00 [revised]
PHST- 2024/03/11 00:00 [accepted]
PHST- 2024/05/17 00:43 [medline]
PHST- 2024/03/17 00:42 [pubmed]
PHST- 2024/03/16 20:25 [entrez]
AID - S1058-2746(24)00184-8 [pii]
AID - 10.1016/j.jse.2024.03.005 [doi]
PST - ppublish
SO  - J Shoulder Elbow Surg. 2024 Jun;33(6S):S93-S103. doi: 10.1016/j.jse.2024.03.005. 
      Epub 2024 Mar 15.