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Scapular Notching in Reverse Shoulder Arthroplasty

  • Giulia NicolaciEmail author
  • Andrea Pautasso
  • Michel Calò
  • Filippo Castoldi
Chapter

Abstract

The complication rate associated with reverse shoulder arthroplasty has been decreasing since its introduction but still remains significant and includes scapular notching. It is actually considered one of the most frequent complications after reverse total shoulder arthroplasty. Scapular notching has been defined as the glenoid neck erosion resulting from the repeated contact of the humeral stem with the inferior scapular neck during the adduction of the arm and also as the effect of a rotational friction during internal and external rotation. The clinical consequences of scapular notching still appear controversial: for some authors, the radiographic image does not have any significant clinical effect; for others, it is related to reduced strength, reduced range of motion, implant loosening, and possible joint instability.

Some risk factors have been described in literature such as an E2 glenoid morphology (Favard’s classification), a shorter scapular neck, a higher grade of infraspinatus muscle atrophy, or an eccentric osteoarthritis with cuff tear arthropathy which has been related to a higher risk of scapular notching. Finally, the anterolateral approach also has been demonstrated to lead to a higher risk of notching.

In this chapter, we review the literature and deliver our personal experience for technical procedures used in order to avoid scapular notching. Biomechanical analysis has demonstrated that both humeral neck-shaft angle and glenosphere placement play the most important role in the reduction of scapular notching incidence and the increase of the range of motion in adduction.

Keywords

Scapular notching RSA Complications 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Giulia Nicolaci
    • 1
    Email author
  • Andrea Pautasso
    • 1
  • Michel Calò
    • 1
  • Filippo Castoldi
    • 1
  1. 1.Orthopaedics and Traumatology UnitSan Luigi Gonzaga HospitalOrbassanoItaly

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