Scapular notching in reverse total shoulder arthroplasty: Now what?

Scapular notching is a well-known complication of reverse total shoulder arthroplasty. While early reports revealed no ill effects on clinical outcomes, later research has shown decreased range of motion, decreased strength, lower Constant scores, and higher pain scores. It appears that lowering the glenosphere on the glenoid decreases contact between the humeral component and the inferior bony pillar, decreasing the rate and grade of notching. Once notching occurs after reverse total shoulder arthroplasty, it appears that close observation in an asymptomatic patient is sufficient. Revisions in symptomatic patients require debridement, bone grafting, and baseplate augments.