Clinical and radiological results of custom-made glenoid implants in reverse total shoulder arthroplasty with a mean follow-up of 36 months.

BACKGROUND

Custom-made glenoid implants (CMGIs) represent a new technology for treating severe glenoid bone deficiencies. Despite the potential advantages of achieving sufficient primary stability and precise implant positioning, its role is not clear due to the scarcity of clinical studies.

METHODS

The first 12 consecutive patients who were treated with CMGIs (ProMade, Enovis) at a single institution were enrolled. At a minimum follow-up (FU) of 2 years (range: 24-76 months; mean 36 months), the clinical outcomes were evaluated using the Constant score, Simple Shoulder Test, and range of motion and compared with pre-operative values. Radiographs were assessed for inferior notching, osteolysis, or other signs of loosening. All complications were recorded.

RESULTS

There was a significant improvement in Constant score (26 to 71 [P < .001]), Simple Shoulder Test (1.9 to 8.5 [P < .001]), and range of motion in all degrees of freedom (P < .05). There were no radiological signs of osteolysis or loosening. Thirty percent of patients were noted to have grade 1 notching. Two patients were not eligible for a 2-year FU (death from unrelated conditions, recurrent infection). An overall complication rate of 25% included dislocation (n = 1), hematoma (n = 1), and a nondisplaced fracture of the humerus (n = 1).

CONCLUSION

CMGIs are an option for the treatment of severe glenoid bone deficiencies at a short- to medium-term follow-up with promising clinical results and no adverse radiological signs. The complication rate is not insignificant, and further studies with longer-term follow-up are suggested.