Scapular notching in reverse shoulder arthroplasty

Case contributed by Domenico Nicoletti ◉

Diagnosis almost certain

Citation, DOI, disclosures and case data

Citation:

Nicoletti D, Scapular notching in reverse shoulder arthroplasty. Case study, Radiopaedia.org (Accessed on 31 Mar 2023) https://doi.org/10.53347/rID-49122

DOI:

https://doi.org/10.53347/rID-49122

Permalink:

https://radiopaedia.org/cases/49122

rID:

49122

Disclosures:

At the time the case was submitted for publication Domenico Nicoletti had no recorded disclosures.

View Domenico Nicoletti's current disclosures

Case published:

10 Nov 2016

Revisions:

11 times, by 2 contributors - see full revision history and disclosures

Systems:

Musculoskeletal

Quiz mode:

Included

Presentation

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

Patient Data

Age: 81

Gender: Male

From the case: Scapular notching in reverse shoulder arthroplasty

x-ray

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Frontal

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.