Clinical and radiographic outcomes of revision to reverse shoulder arthroplasty with an augmented baseplate in the setting of glenoid bone loss

Background In revision to reverse shoulder arthroplasty (RSA), improper correction of glenoid deformity can result in over-medialization, baseplate fixation compromise, or variation in baseplate inclination or version. This study assessed clinical and radiographic outcomes of a non-custom augmented baseplate in the setting of revision to RSA. Methods This was a retrospective cohort study of patients who underwent revision to RSA (from a prior shoulder arthroplasty procedure) with an augmented baseplate with a minimum 2-year follow-up. Radiographic and clinical outcomes were assessed. Results Revision to RSA with a baseplate augment was performed in 25 patients (age 68.2 ± 8.9 years). There was improvement in elevation (98 to 146, p < 0.001), external rotation (28 to 39, p = 0.032), American Shoulder and Elbow Surgeon score (36.5 to 75.4, p < 0.001), Single Alpha Numeric Evaluation score (30.1 to 70.0, p < 0.001), and Visual Analog Pain Score (6.2 to 2.3, p < 0.001). One patient had radiographic evidence of baseplate mechanical failure (4%), two cases had postoperative instability (8%), and two cases had periprosthetic humerus fractures (8%). Discussion In the setting of glenoid bone loss and revision to RSA, baseplate full and half-wedge “off-the-shelf” augments provide favorable short-term outcomes with a low rate of baseplate failure (4%) at a mean 2.7-year follow-up. Level of evidence Level IV, retrospective cohort study.