Inferior tilt of the glenoid component does not decrease scapular notching in reverse shoulder arthroplasty: results of a prospective randomized study

Hypothesis: The purpose of this study was to determine if inferior tilt of the glenoid component decreased the amount of radiographic scapular notching after reverse shoulder arthroplasty. A secondary goal was to determine if inferior tilt had any effect on clinical outcome. Materials and methods: A prospective randomized trial of 52 consecutive reverse shoulder arthroplasties performed by 1 surgeon for cuff tear arthropathy was performed. The subjects were randomly assigned to receive a glenoid component with no inferior tilt (control group) or a glenoid component that was inferiorly tilted 10 degrees to protect the inferior glenoid (inferior tilt group). All glenoid components were placed in 3 mm of inferior translation. Radiographic notching was graded at a minimum of 1 year after surgery. Clinical outcomes of the groups were recorded. Results: Follow-up radiographs and data were available for 42 subjects, 20 in the inferior tilt group and 22 in the control group. The experimental groups did not differ significantly in the notch ratings or clinical outcomes. Notching occurred in 15 patients (75%) in the inferior tilt group and in 19 (86%) in the control group. Notching scores were 2 or greater in 10 patients (50%) in the inferior tilt group and in 11 (50%) in the control group. Conclusion: Placing the glenoid component with inferior tilt does not reduce the incidence or severity of radiographic scapular notching after reverse shoulder arthroplasty. No clinical differences were observed between the groups. (c) 2012 Journal of Shoulder and Elbow Surgery Board of Trustees.