Scapular notching in reverse shoulder arthroplasty

Case contributed by Dr Domenico Nicoletti

Presentation

Severe pain after three years of reverse prosthesis implantation for complete supraspinatus and subscapularis lesion

Patient Data

Age: 81
Gender: Male

There is erosion of the lower edge of the scapular glenoid due to impingement of the humeral insert versus the scapula.

Case Discussion

With this type of prosthesis the center of rotation is shifted medial about 2 cm in order to increase the lever arm of the deltoid muscle.

This solution increases the risk of glenoid erosion and instability of glenosphere.

To overcome this risk the prosthesis is enlarged, lowered and tilted medially (glenosphere eccentric) while the humeral insert creates a medial recess.

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