Scapular notching: Danger ahead?

Scapular notching is a radiographic finding in patients that have had a reverse total shoulder arthroplasty. It has been linked to decreased range of motion, strength, and increased pain. It occurs most commonly in the early postoperative period but can be progressive. The incidence of scapular notching reported in the current literature ranges from 9.7% to 68%. This wide range can be attributed to the variable positioning of the glenosphere on the glenoid. To decrease the occurrence of scapular notching, it appears that the optimal positioning of the scapular component is inferior on the glenoid so the prosthesis will be anchored below the native glenoid. This prevents the humeral component from making contact with the glenoid neck and inferior bony pillar.