Elective Reverse Shoulder Arthroplasty with Bigliani Stem: Clinical and Radiological Outcomes at Medium and Long Term

Background/Objectives: The aim of this study was to report the mid to long-term clinical and radiographic results of patients affected by massive rotator cuff tear, cuff tear arthropathy, or primary osteoarthritis that underwent reverse total shoulder replacement with the Bigliani stem. Methods: Patients’ data such as age at index surgery, gender, side and dominancy, comorbidities, complications, and type of glenoid component were prospectively collected. Range of motion, Constant score weighted on the contralateral shoulder, Quick-DASH, Oxford Shoulder Score, and Subjective Shoulder Value were also recorded, both pre-operatively and at follow-up evaluations. Radiographical complications were assessed with x-rays (anteroposterior, Grashey, and axillary views). Results: 60 implants were included, with an average follow-up of 43 months. Mean values for the range of motion were: anterior elevation 138,5°, abduction 132,8°, external rotation 26,5°, internal rotation between the sacro-iliac joint and the waist. Mean values for the scores were: Constant score 67, Quick-DASH 26, Oxford Shoulder Score 39, Subjective Shoulder Value 81. 2 implants required revision (3%), 3 patients developed acromial stress fractures (5%), the remaining 55 showed no complications (92%). Male patients had better Constant score results, and patients implanted with Zimmer TM glenoid component had better internal rotation results compared to those implanted with Zimmer Comprehensive. Conclusions: The Bigliani stem is associated with good clinical and radiographic results. Range of motion, functional scores, and complication rate were comparable to what described in literature for newer, shorter stem. This finding confirms that the Bigliani stem is a valid treatment option and underlines the importance of future long-term investigations to determine the best component combination in reverse total shoulder arthroplasty

ABSTRACT Background/Objectives: The aim of this study was to report the mid to long-term clinical and radiographic results of patients affected by massive rotator cuff tear, cuff tear arthropathy, or primary osteoarthritis that underwent reverse total shoulder replacement with the Bigliani stem. Methods: Patients’ data such as age at index surgery, gender, side and dominancy, comorbidities, complications, and type of glenoid component were prospectively collected. Range of motion, Constant score weighted on the contralateral shoulder, Quick-DASH, Oxford Shoulder Score, and Subjective Shoulder Value were also recorded, both pre-operatively and at follow-up evaluations. Radiographical complications were assessed with x-rays (anteroposterior, Grashey, and axillary views). Results: 60 implants were included, with an average follow-up of 43 months. Mean values for the range of motion were: anterior elevation 138,5°, abduction 132,8°, external rotation 26,5°, internal rotation between the sacro-iliac joint and the waist. Mean values for the scores were: Constant score 67, Quick-DASH 26, Oxford Shoulder Score 39, Subjective Shoulder Value 81. 2 implants required revision (3%), 3 patients developed acromial stress fractures (5%), the remaining 55 showed no complications (92%). Male patients had better Constant score results, and patients implanted with Zimmer TM glenoid component had better internal rotation results compared to those implanted with Zimmer Comprehensive. Conclusions: The Bigliani stem is associated with good clinical and radiographic results. Range of motion, functional scores, and complication rate were comparable to what described in literature for newer, shorter stem. This finding confirms that the Bigliani stem is a valid treatment option and underlines the importance of future long-term investigations to determine the best component combination in reverse total shoulder arthroplasty