JSES - 2026-08-21 - Journal Article
Comparing Inferiorized and Lateralized Glenospheres in Reverse Total Shoulder Arthroplasty Using the LimaCorporate SMR Reverse Shoulder System: A Single-Center Analysis.
Pearsall C, Lachance A, Whittemore C, Neumann D, Choi J
Topics
Key Takeaway
Inferiorized and lateralized glenospheres in rTSA showed equivalent 36-month cumulative incidence of reoperation (4.9% vs. 4.4%) and equivalent ASES improvements (~46–50 points) with no significant difference in any outcome.
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Summary
This single-surgeon, single-institution retrospective study compared reoperation rates, PROs, and mortality between inferiorized and lateralized glenospheres in primary rTSA using the LimaCorporate SMR system. Competing-risks methodology with IPW adjustment found no significant difference in 36-month CIR (4.9% vs. 4.4%), ASES improvement (46.2 vs. 50.2 points), VAS pain reduction (-4.2 vs. -4.2), MCID achievement (~82–87%), or mortality (4% vs. 1.5%). Glenosphere type was not independently associated with any endpoint after multivariable adjustment.
Key Limitation
The substantially shorter median follow-up in the lateralized cohort (12.2 vs. 31.3 months) makes it impossible to determine whether differences in notching, acromial stress fracture, or implant loosening emerge at mid-term follow-up.
Original Abstract
BACKGROUND
Limited evidence compares reoperation, patient-reported outcomes (PROs), and mortality between inferiorized and lateralized glenospheres in reverse total shoulder arthroplasty (rTSA).
METHODS
Single-institution retrospective review was performed of all primary rTSAs performed by a single surgeon using the LimaCorporate SMR Reverse Shoulder System between 2014 and 2025. Demographics, surgical data, reoperation, mortality, and PROs were obtained; American Shoulder and Elbow Surgeons (ASES) and visual analog scale (VAS) pain scores were collected preoperatively and postoperatively between 6 and 12 months. Cumulative incidence of reoperation (CIR) was estimated using competing-risks methodology with death as a competing event; group differences were assessed using Fine-Gray regression. Inverse probability weighting (IPW) was used to adjust for confounding in multivariable regression analyses assessing the association between glenosphere type and each endpoint.
RESULTS
Overall, 329 inferiorized and 131 lateralized glenospheres were included with respective mean ages of 72.9 and 71.6 years (p=0.60), minimum follow up of 12 months, median follow-up of 31.3 and 12.2 months (p<0.001), and PRO completion percentages of 59% and 64% (p=0.77). There were no significant differences between inferiorized and lateralized glenospheres with respect to 36-month CIR (4.9% versus 4.4%; p=0.37), with similar findings at 12 and 24 months, improvements in ASES (46.2 vs. 50.2; p=0.26) or VAS pain (-4.2 vs. -4.2; p=0.97), minimal clinically important difference achievement for ASES (87.1% vs. 84.5%; p=0.57) or VAS pain (82.5% vs. 78.6%; p=0.50), and mortality (4% vs. 1.5%; p=0.25). Glenosphere type was not significantly associated with CIR, reoperation, PROs, or mortality.
CONCLUSION
Within the limitations of this retrospective study, inferiorized and lateralized glenospheres using the LimaCorporate SMR Reverse Shoulder System demonstrated comparable short-term clinical outcomes despite differing follow-up durations between cohorts. Longer-term follow-up is needed to determine whether clinically meaningful differences emerge over time.
LEVEL OF EVIDENCE
Level III, Retrospective Cohort Comparison, Treatment Study.