JSES - 2026-04-01 - Journal Article; Multicenter Study
Incidence and risk factors for aseptic glenoid baseplate loosening in primary reverse shoulder arthroplasty using the Aramis implant baseplate with a minimum of 2 years follow-up.
Klein A, Nové-Josserand L, Collotte P, Gunst S
Topics
Key Takeaway
Aseptic glenoid baseplate loosening occurred in 5.7% of Aramis rTSA cases at mean 4.2 years, independently predicted by intraoperative glenoid fracture (OR 15) and excessive lateral component positioning (OR 1.07 per degree).
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Summary
This retrospective multicenter study examined AGBL incidence and risk factors in 194 primary rTSA cases using the Aramis lateralized-glenoid/lateralized-humerus convex baseplate implant with minimum 2-year follow-up. AGBL occurred in 11 cases (5.7%); multivariable analysis identified intraoperative glenoid fracture (OR 15, 95% CI 1.4–157) and excessive lateral positioning by lateralization shoulder angle (OR 1.07 per degree, 95% CI 1.00–1.14) as independent predictors. High glenoid component position, insufficient distalization, and inferior glenoid pillar bone spurs were significant on univariable analysis but did not reach independence.
Key Limitation
Only 11 AGBL events in 194 cases produces an underpowered multivariable model with extremely wide confidence intervals, making the independent effect estimates—particularly for glenoid fracture—statistically unstable and potentially ungeneralizable.
Original Abstract
BACKGROUND
Reverse total shoulder arthroplasty (rTSA) has become the gold standard treatment for many shoulder pathologies. Aseptic glenoid baseplate loosening (AGBL) is a serious complication of rTSA that may lead to revision surgery. The aim of this study was to evaluate the incidence of AGBL in patients who underwent rTSA using a lateralized-glenoid lateralized-humerus implant with a convex baseplate. The secondary objective was to identify risk factors for AGBL.
METHODS
This retrospective multicenter study included 194 rTSA with the same prosthesis design (Aramis) implanted between 2013 and 2019 by 2 senior surgeons with a minimum follow-up of 2 years. All patients were evaluated clinically and radiographically before surgery and at last follow-up. Demographic variables, implant characteristics, operative parameters, and rates of scapular notching and of bone spurs at the level of the inferior glenoid pillar were compared between cases with and without AGBL.
RESULTS
AGBL occurred after 11 of 194 rTSA (5.7%). The mean follow-up was 4.2 ± 1.8 years (range, 2-9.3 years). In univariable analysis, AGBL was significantly associated (P < .05) with intraoperative glenoid fracture, high-positioned glenoid component, and insufficiently distal rTSA (low distalization shoulder angle). Spurs at the level of the inferior glenoid pillar were also significantly more prevalent in the AGBL group (P = .006). In multivariable analysis, the variables independently associated with AGBL were intraoperative glenoid fracture (odds ratio 15, 95% confidence interval [1.4; 157]; P = .027), and excessively lateral positioning of the implant (high lateralization shoulder angle) (odds ratio, 1.07 [1.00; 1.14]; P = .045).
CONCLUSIONS
In this series of 194 rTSA with a lateralized-glenoid lateralized-humeral implant and convex baseplate, the incidence of AGBL at a mean follow-up of 4.2 years was 5.7%. AGBL was independently associated with intraoperative glenoid fracture and excessively lateral positioning of the implant.