This armed surgeons with a new solution for treating shoulder replacement patients who suffer from severe glenoid deformity. As the first company to develop and market this technology, Exactech relied on years of experience in reverse biomechanics to develop a full range of Equinoxe glenoid options.
A full range of Equinoxe® glenoid options + ExactechGPS® navigation =
10 Years of Glenoid Augment Reality
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Ten years ago, Exactech introduced the Equinoxe® shoulder system’s augmented reverse baseplate.
View recent studies that demonstrate the improvements these augments can provide
J Shoulder Elbow Surg.
Clinical and radiographic outcomes with a posteriorly augmented glenoid for Walch B2, B3, and C glenoids in reverse total shoulder arthroplasty.
Read Abstract
Clinical and radiographic outcomes with a posteriorly augmented glenoid for Walch B2, B3, and C glenoids in reverse total shoulder arthroplasty.
Virk, M. et al. Clinical and radiographic outcomes with a posteriorly augmented glenoid for Walch B2, B3, and C glenoids in reverse total shoulder arthroplasty. J Shoulder Elbow Surg. 2020 May;29(5):e196-e204.
Introduction:
The purpose of this study is to quantify the clinical and radiographic outcomes of patients with severe posterior glenoid wear who were treated with reverse total shoulder arthroplasty (rTSA) and a posterior augment baseplate.
Methods:
67 primary rTSA patients with osteoarthritis and posterior glenoid wear were treated with an 8° posterior augmented glenoid baseplate. All patients had a Walch B2, B3, or C glenoid, 2-year minimum follow-up, and had a mean follow-up of 40 months. All patients were scored preoperatively and at latest follow-up using 5 clinical outcome metrics; active range of motion was also measured. A Student’s two-tailed, unpaired t-test quantified differences in outcomes, where p<0.05 denoted significance.
Results:
All patients experienced significant improvements in pain and function following primary rTSA with a posterior augment glenoid baseplate. Three complications were reported for a rate of 4.5%; no cases of aseptic glenoid loosening occurred. 90% of patients exceeded the minimal clinically important difference threshold and 80% of patients exceeded the substantial clinical benefit threshold for each clinical outcome metric and range of motion measure. No differences in outcomes or complications were observed between Walch B2 and B3 patients, demonstrating this full-wedge posterior augment baseplate was equally good in each type of glenoid deformity.
Discussion:
Primary rTSA patients with Walch B2, B3, and C glenoids who received an 8° posterior augment glenoid baseplate experienced excellent clinical and radiographic outcomes with a low complication rate and no reports of aseptic glenoid loosening at a mean follow-up of 40 months.
J Bone Joint Surg Am.
Reverse total shoulder arthroplasty with a superior augmented glenoid component for Favard type-E1, E2, and E3 glenoids.
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Reverse total shoulder arthroplasty with a superior augmented glenoid component for Favard type-E1, E2, and E3 glenoids.
Liuzza, L. et al. Reverse total shoulder arthroplasty with a superior augmented glenoid component for Favard type-E1, E2, and E3 glenoids. J Bone Joint Surg Am. 2020 Nov 4;102(21):1865-1873.
Background:
Uncorrected superior glenoid wear in patients managed with reverse total shoulder arthroplasty (rTSA) can result in increased complications, including baseplate failure. The present study quantifies the clinical and radiographic outcomes of patients with Favard type-E1, E2, and E3 glenoid deformity who were managed with rTSA with use of a superior or superior/posterior augmented glenoid baseplate.
Methods:
We retrospectively reviewed the records for 68 patients with shoulder arthritis and Favard type-E1, E2, or E3 glenoid deformity who were managed with primary rTSA and a 10° superior augmented or 10° superior/8° posterior augmented baseplate. The mean duration of follow-up was 40 months (range, 24 to 85 months). Outcomes were assessed preoperatively and at the latest follow-up with shoulder range of motion and use of outcome scores including the Simple Shoulder Test (SST), University of California Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, Constant score, and Shoulder Pain and Disability Index (SPADI) score. Radiographs were evaluated preoperatively and at the time of the latest follow-up. Differences in preoperative and postoperative range of motion and outcome metrics were assessed with use of a 2-tailed Student t test.
Results:
The majority of patients experienced clinically meaningful improvements in terms of pain and function following rTSA with a superior or superior/posterior augment, with 94% of patients rating themselves as “much better” (73.5%) or “better” (20.5%) at the time of the latest follow-up. At least 88% of the patients exceeded the minimum clinically important difference (MCID) threshold, and 75% of patients exceeded the substantial clinical benefit (SCB) threshold, for each of the clinical outcome metrics and range of motion. Five complications were reported (prevalence, 7.4%), including acromial stress fracture (2 patients), posttraumatic scapular neck fracture (1 patient), chronic shoulder pain (1 patient), and aseptic glenoid loosening (1 patient).
Conclusions:
The present short-term clinical and radiographic study demonstrated that shoulder arthropathy with superior glenoid wear patterns (Favard types E1, E2, and E3) can be successfully treated with rTSA with a superior or superior/posterior augmented baseplate. Longer-term clinical and radiographic follow-up is necessary to confirm that these promising short-term results are durable.
Seminars in Arthroplasty: JSES. 2021 In press.
Clinical outcomes of augmented rTSA glenoid baseplates.
Read Abstract
Clinical outcomes of augmented rTSA glenoid baseplates. Presented at ASES 2019 (Nominated for Neer Award).
Gulotta, L. et al. Clinical outcomes of augmented rTSA glenoid baseplates. Presented at ASES 2019 (Nominated for Neer Award). Seminars in Arthroplasty: JSES. 2021 In press.
Background:
Glenoid wear is a common challenge in patients undergoing reverse total shoulder arthroplasty (rTSA). Augmented baseplates have recently been designed to address this. The purpose of this study is to determine the clinical outcomes, complications, and revision rates of patients undergoing rTSA with an augmented baseplate compared to those that received a standard, non-augmented baseplate.
Methods:
Preoperative and postoperative data were analyzed for 341 patients with glenoid bone loss who underwent primary rTSA with either an 8° posterior augmented glenoid baseplate (PAB), a 10° superior augmented baseplate (SAB), or an 8° posterior/10° superior augmented baseplate (P/SAB). These patients were compared to 1491 primary rTSA patients who received a standard baseplate. Clinical outcomes were scored using the Simple Shoulder Test (SST), UCLA, ASES, Constant and SPADI clinical outcome scoring metrics. Range of motion for active abduction, forward flexion, internal rotation and external rotation were used to quantify function. Complication and revision rates were also documented, and post-operative radiographs were analyzed for scapular notching. A two-tailed, unpaired t-test was used to identify differences between continuous parameters and a Chi Sq test was used for categorical parameters, with p<0.05 denoting a significant difference.
Results:
At an average follow-up of 45.7 ± 22.5 months, the augmented baseplates performed as well, or better, than standard baseplates, with a similar complication rate and scapular notching rate.
Conclusion:
Augmented baseplates are a safe and effective option for patients with glenoid bone loss in the setting of rTSA at midterm follow-up. For each baseplate type, the outcomes were similar, and the complication/revision and scapular notching rates were low and comparable to that of the standard baseplate cohort.
...Preoperative planning software combined with ExactechGPS® navigation has been eye opening; I now find I use an augment 90% of the time. Augments restore the joint line, have very predictable outcomes and, with ExactechGPS navigation, save time...
Thomas Wright, MDUniversity of Florida College of Medicine, Gainesville, FL
Today, Equinoxe glenoids, combined with ExactechGPS® navigation, help shoulder surgeons visualize their options and execute their plans for shoulder replacement surgery.
