Incidence and risk factors for aseptic glenoid baseplate loosening in primary reverse shoulder arthroplasty using the Aramis© implant baseplate with a minimum of two years follow-up.

Abstract

Reverse total shoulder arthroplasty (rTSA) has become the gold standard treatment for many shoulder pathologies. Aseptic glenoid baseplate loosening (AGBL) is a serious complication of rTSA that may lead to revision surgery. The aim of this study was to evaluate the incidence of AGBL in patients who underwent rTSA using a lateralized-glenoid lateralized-humerus implant with a convex baseplate. The secondary objective was to identify risk factors for AGBL. This retrospective multicenter study included 194 rTSA with the same prosthesis design (Aramis) implanted between 2013 and 2019 by two senior surgeons with a minimum follow-up of 2 years. All patients were evaluated clinically and radiographically before surgery and at last follow-up. Demographic variables, implant characteristics, operative parameters, and rates of scapular notching and of bone spurs at the level of the inferior glenoid pillar were compared between cases with and without AGBL. AGBL occurred after 11/194 rTSA (5.7%). The mean follow-up was 4.2 ± 1.8 years (range, 2 to 9.3 years). In univariable analysis, AGBL was significantly associated (P < .05) with intraoperative glenoid fracture, high-positioned glenoid component, and insufficiently distal rTSA (low distalization shoulder angle). Spurs at the level of the inferior glenoid pillar were also significantly more prevalent in the AGBL group (P = .006). In multivariable analysis, the variables independently associated with AGBL were intraoperative glenoid fracture (odds ratio (OR) 15, 95% confidence interval [1.4; 157]; P =.027), and excessively lateral positioning of the implant (high lateralization shoulder angle) (OR, 1.07 [1.00; 1.14]; P = .045). In this series of 194 rTSA with a lateralized-glenoid lateralized-humeral implant and convex baseplate, the incidence of AGBL at a mean follow-up of 4.2 years was 5.7%. AGBL was independently associated with intraoperative glenoid fracture and excessively lateral positioning of the implant. Level IV; Case Series; Treatment Study.