International Orthopaedics

, Volume 42, Issue 9, pp 2159–2164 | Cite as

Reverse total shoulder arthroplasty using helical blade to optimize glenoid fixation and bone preservation: preliminary results in thirty five patients with minimum two year follow-up

  • Sebastien Zilber
  • Eleonora Camana
  • Peter Lapner
  • Emil Haritinian
  • Laurent Nove Josserand
Original Paper



Glenoid loosening is a common cause of reverse total shoulder arthroplasty (RTSA) failure, and grafting of the glenoid is often required for revision due to bone loss due to the central peg in most glenoid baseplates. Helical blades have been used in the hip to optimize bone fixation in proximal femoral fracture. This study presents the initial results of specifically designed helical blade in the shoulder to optimize glenoid bone fixation and preservation as part of RTSA.


Thirty-five patients underwent RTSA with glenoid helical blade fixation. An uncemented glenoid baseplate was used with a central helical blade partially coated with hydroxyapatite and two or three screws. Outcome analysis was performed pre-operatively and at two years.


All patients were satisfied with the results and significant improvement was observed in functional outcome scores between baseline and final follow-up. There was a single intra-operative undisplaced glenoid fracture which did not compromise the baseplate fixation. There was no radiographic evidence of loosening or radiolucencies around the helical blade.


The helical blade provides a satisfactory primary fixation. Because of its length (21 mm), care should be taken in cases of pre-existing bone loss or sclerotic bone to avoid glenoid fracture or anterior cortical perforation. Helical blade has the potential to facilitate glenoid implant revision by preserving the glenoid bone stock.


Reverse shoulder arthroplasty Glenoid fixation Helical blade Shoulder Arthroplasty Glenoids 


  1. 1.
    Bacle G, Nové-Josserand L, Garaud P, Walch G (2017) Long-term outcomes of reverse total shoulder arthroplasty: a follow-up of a previous study. J Bone Joint Surg Am 99:454–461. CrossRefPubMedGoogle Scholar
  2. 2.
    King J, Nystrom L, Reimer N et al (2016) Allograft-prosthetic composite reverse total shoulder arthroplasty for reconstruction of proximal humerus tumor resections. J Shoulder Elb Surg 25:45–54. CrossRefGoogle Scholar
  3. 3.
    Boileau P, Watkinson D, Hatzidakis A, Walch G (2006) Neer Award 2005: the Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J Shoulder Elb Surg 15:527–540CrossRefGoogle Scholar
  4. 4.
    Anakwenze O, Zoller S, Ahmad C, Levine W (2014) Reverse shoulder arthroplasty for acute proximal humerus fractures: a systematic review. J Shoulder Elb Surg 23:73–80. CrossRefGoogle Scholar
  5. 5.
    Postacchini R, Carbone S, Canero G et al (2016) Reverse shoulder prosthesis in patients with rheumatoid arthritis: a systematic review. Int Orthop 40:965–973. CrossRefPubMedGoogle Scholar
  6. 6.
    Black E, Roberts S, Siegel E et al (2015) Failure after reverse total shoulder arthroplasty: what is the success of component revision? J Shoulder Elb Surg 24:1908–1914. CrossRefGoogle Scholar
  7. 7.
    Boileau P (2016) Complications and revision of reverse total shoulder arthroplasty. Orthop Traumatol Surg Res 102:33–43. CrossRefGoogle Scholar
  8. 8.
    Holcomb J, Cuff D, Petersen S et al (2009) Revision reverse shoulder arthroplasty for glenoid baseplate failure after primary reverse shoulder arthroplasty. J Shoulder Elb Surg 18:717–723. CrossRefGoogle Scholar
  9. 9.
    Hopkins A, Hansen U, Bull A et al (2008) Fixation of the reversed shoulder prosthesis. J Shoulder Elb Surg 17:974–980. CrossRefGoogle Scholar
  10. 10.
    Wagner E, Houdek M, Griffith T et al (2015) Glenoid bone-grafting in revision to a reverse total shoulder arthroplasty. J Bone Joint Surg Am 97:1653–1660. CrossRefPubMedGoogle Scholar
  11. 11.
    Zumstein M, Pinedo M, Old J, Boileau P (2011) Problems, complications, reoperations, and revisions in reverse total shoulder arthroplasty: a systematic review. J Shoulder Elb Surg 20:146–157. CrossRefGoogle Scholar
  12. 12.
    Goffin J, Pankaj P, Simpson A et al (2013) Does bone compaction around the helical blade of a proximal femoral nail anti-rotation (PFNA) decrease the risk of cut-out?: a subject-specific computational study. Bone Joint Res 2:79–83. CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Bercik M, Kruse K 2nd, Yalizis M et al (2016) A modification to the Walch classification of the glenoid in primary glenohumeral osteoarthritis using three-dimensional imaging. J Shoulder Elb Surg 25:1601–1606. CrossRefGoogle Scholar
  14. 14.
    Hamada K, Fukuda H, Mikasa M, Kobayashi Y (1990) Roentgenographic findings in massive rotator cuff tears. A long-term observation. Clin Orthop Relat Res 254:92–96Google Scholar
  15. 15.
    Flurin P-H, Roche CP, Wright TW et al (2015) A comparison and correlation of clinical outcome metrics in anatomic and reverse total shoulder arthroplasty. Bull Hosp Jt Dis 2013(73 Suppl 1):S118–S123Google Scholar
  16. 16.
    Urch E, Dines JS, Dines DM (2016) Emerging indications for reverse shoulder arthroplasty. Instr Course Lect 65:157–169PubMedGoogle Scholar
  17. 17.
    Constant CR, Gerber C, Emery RJH et al (2008) A review of the Constant score: modifications and guidelines for its use. J Shoulder Elb Surg 17:355–361. CrossRefGoogle Scholar
  18. 18.
    Gilbart MK, Gerber C (2007) Comparison of the subjective shoulder value and the Constant score. J Shoulder Elb Surg 16:717–721. CrossRefGoogle Scholar
  19. 19.
    Sirveaux F, Favard L, Oudet D et al (2004) Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Shoulder Elb Surg 86:388–395Google Scholar
  20. 20.
    Mereddy P, Kamath S, Ramakrishnan M et al (2009) The AO/ASIF proximal femoral nail antirotation (PFNA): a new design for the treatment of unstable proximal femoral fractures. Injury 40:428–432. CrossRefPubMedGoogle Scholar
  21. 21.
    Simmermacher RKJ, Ljungqvist J, Bail H et al (2008) The new proximal femoral nail antirotation (PFNA?) in daily practice: results of a multicentre clinical study. Injury 39:932–939. CrossRefPubMedGoogle Scholar
  22. 22.
    Lenich A, Vester H, Nerlich M et al (2010) Clinical comparison of the second and third generation of intramedullary devices for trochanteric fractures of the hip—blade vs screw. Injury 41:1292–1296. CrossRefPubMedGoogle Scholar
  23. 23.
    Ma K-L, Wang X, Luan F-J et al (2014) Proximal femoral nails antirotation, gamma nails, and dynamic hip screws for fixation of intertrochanteric fractures of femur: a meta-analysis. Orthop Traumatol Surg Res 100:859–866. CrossRefPubMedGoogle Scholar
  24. 24.
    Humphrey CS, Kelly JD, Norris TR (2008) Optimizing glenosphere position and fixation in reverse shoulder arthroplasty, part two: the three-column concept. J Shoulder Elb Surg 17:595–601. CrossRefGoogle Scholar
  25. 25.
    James J, Allison M, Werner F et al (2013) Reverse shoulder arthroplasty glenoid fixation: is there a benefit in using four instead of two screws? J Shoulder Elb Surg 22:1030–1036. CrossRefGoogle Scholar
  26. 26.
    Codsi MJ, Bennetts C, Gordiev K et al (2008) Normal glenoid vault anatomy and validation of a novel glenoid implant shape. J Shoulder Elb Surg 17:471–478. CrossRefGoogle Scholar
  27. 27.
    Hsu J, Namdari S, Baron M et al (2014) Glenoid perforation with pegged components during total shoulder arthroplasty. Orthopedics 37:e587–e591. CrossRefPubMedGoogle Scholar
  28. 28.
    Press C, O’Connor D, Elkousy H et al (2014) Glenoid perforation does not affect the short-term outcomes of pegged all-polyethylene implants in total shoulder arthroplasty. J Shoulder Elb Surg 23:1203–1207. CrossRefGoogle Scholar

Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.Department of Orthopedic SurgeryHenri Mondor Teaching HospitalCreteilFrance
  2. 2.Shoulder UnitSanty Orthopedic CenterLyonFrance
  3. 3.Division of Orthopaedic SurgeryUniversity of OttawaOttawaCanada

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