Quantifying bone loss and lateralization with standardized baseplate versus augmented baseplates

Reverse shoulder arthroplasty continues to be utilized for the treatment of cuff tear arthropathy, glenohumeral degenerative joint disease, and irreparable rotator cuff tears. With advancement in component designs, glenoid retroversion and inclination are now correctable with augmented baseplates. However, quantifying bone loss and lateralization compared to standard baseplates has not been studied. The purpose of the current study is to determine the volume of bone reamed and net lateralization with a standardized baseplate vs. augmented baseplate when glenoid inclination was corrected to neutral. A series of 21 computed tomography scans of patients presenting for shoulder arthroplasty were chosen based on a range of increasing native positive inclination. Computed tomography scans were uploaded into segmentation software and processed. Four fellowship trained shoulder surgeons were then blinded from each other and virtually placed a neutral baseplate and an augmented baseplate for each specimen. Baseplate position was standardized. Additionally, baseplate backside seating of a minimum of 80% was also standardized and glenosphere (nonlateralized) size was selected to eliminate variation in baseplate contact and position. Glenoid inclination was corrected to a minimal of neutral in each specimen as well as glenoid retroversion corrected to .05). There was substantially lower volume of bone reamed in the augmented baseplate patients (619 mm3 vs. 1102 mm3, P