Absence of scapular notching in lateralized reverse shoulder arthroplasty: a mid-term clinical and radiological evaluation

Background: Lateralized reverse shoulder arthroplasty (LRSA) has been conceived to improve clinical and functional outcomes and reduce complication rates and scapular notching in comparison with medialized implant. The purpose of this study was to evaluate the mid-term clinical and radiological outcomes, the survival rate, and the health-related quality of life in a prospective series of patients who underwent LRSA and to identify the possible predictors of clinical outcomes. Methods: We conducted a retrospective study on prospectively collected data of 29 patients who underwent LRSA. Thirteen (45%) patients suffered from primary osteoarthritis (OA), 12 (41%) patients suffered from cuff tear arthropathy, and 4 (14%) patients suffered from secondary OA due to fracture sequelae. Each patient was evaluated preoperatively and at follow-up by radiological and computed tomography and by assessing the range of motion, the Constant–Murley Score, and the short form 12. Results: After a mean follow-up of 52.3 ± 17.4 (range, 24-101) months, a statistically significant recovery of the forward flexion, abduction, and external rotation range of motion as well as the Constant–Murley Score and short form 12 physical component values was reported. Higher postoperative functional outcomes were noted in patients suffering from primary OA in comparison with patients suffering from cuff tear arthropathy or secondary OA. No cases of scapular notching (0%) and just one case (3.4%) of grade 1 heterotopic ossification were observed. Conclusions: Satisfactory clinical and radiological outcomes of LRSA can be expected after a mean 52.3-month follow-up, with no cases of scapular notching and exceptionally low rates of radiological complications.