Custom Reverse Shoulder Arthroplasty for Severe Postoperative Glenoid Bone Defects: A Retrospective Case Series
Abstract
Introduction: Glenoid bone loss complicates revision reverse shoulder arthroplasty. Patient-specific 3D-printed glenoid implants allow accurate reconstruction of severe defects. Objective: To evaluate the clinical and radiographic outcomes of customized glenoid baseplates in revision reverse shoulder arthroplasty with severe glenoid defects, and to record intraoperative and postoperative complications. Materials and Methods: A retrospective series of eight consecutive patients (June 2022-May 2023) with Gohl-ke type ≥3 defects who underwent revision reverse shoulder arthroplasty with 3D-planned titanium glenoid baseplates based on computed tomography. Range of motion, function, pain, surgical time, and radiographic integration were analyzed, with a 12-month follow-up. Results: Range of motion improved significantly: forward elevation increased by 78.8° (p < 0.001), external rotation by 7.5° (p = 0.019), and internal rotation improved from the gluteal level (trochanter-L5) to a mean of T12 (range: T7-gluteal level). Pain decreased by 6.4 points (p < 0.001). The Constant-Murley score increased by 48.9 points (p < 0.001). Complete osseointegration was observed in 7 cases; the remaining case showed radiolucent lines without loosening. No major complications were recorded. Conclusions: In revision reverse shoulder arthroplasty with severe glenoid bone defects, 3D-printed glenoid baseplates restore anatomy, significantly improve function, and reduce pain at one year, with a high rate of integration and low morbidity.Downloads
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