Bony increased offset reverse shoulder arthroplasty (BIO-RSA) vs metal augments: A systematic review
摘要
Lateralisation in reverse shoulder arthroplasty can be achieved through bone graft (BIO-RSA) or metal augments (MIO-RSA). This systematic review and meta-analysis aimed to compare outcomes in both these methods.
Materials and methodsA systematic review of Pubmed, Cochrane, Medline and EMBASE was performed including all studies on primary reverse total shoulder replacements with lateralised glenoid components using either bone graft (BIO-RSA) or metal augments (MIO-RSA). Collected data for included studies included demographics, method of lateralisation and complications.
Results30 studies comprising 2364 shoulders in 2558 patients were included, with a mean age of 72.8 (23–93), and 59.7% being female. 1026 patients underwent BIO-RSA and 1328 underwent arthroplasty with metal augmented glenoid components. After 31.5 months (3–126) follow-up, there was a significantly lower pain score (p < 0.05) and higher ASES (p < 0.05) and UCLA (p < 0.05) scores in patients post MIO-RSA, but no significant difference in range of movement post-operatively. Moreover, there was lower rates of revisions (1.3% v 3.0%, p < 0.01), loosening (0.8% v 2.4%, p < 0.01) and scapular notching (3.8% v 17.3%, p < 0.01) in the MIO-RSA group.
ConclusionsBIO-RSA and MIO-RSA outcomes are summarised, suggesting preliminary evidence of some superiority of MIO-RSA, but heterogeneity in the selected studies limits the conclusions that can be drawn from results. Long term studies are required to ascertain if this effect is maintained.