The impact of peripheral screw configuration and greater tuberosity migration on stability and functional outcomes in reverse shoulder arthroplasty

Reverse shoulder arthroplasty (RSA) has been a widely used surgical intervention for management of complex shoulder pathologies, including proximal humeral fractures, rotator cuff arthropathy and severe shoulder osteoarthritis. However, two critical independent factors may potentially influence postoperative outcomes: (1) the number of peripheral screws used for glenoid fixation and (2) greater tuberosity migration. This study analysed a cohort of 28 RSA patients to assess whether the number of peripheral screws affects loosening rates and whether postoperative greater tuberosity migration impairs abduction and forward flexion. Statistical analysis revealed no significant association between screw count and loosening (p = 0.62), but tuberosity migration was linked to significantly reduced abduction (p = 0.028). These findings suggest that surgical focus should prioritize the stability of tuberosity fixation, also excessive peripheral screw use may not be necessary.