Objective: To evaluate the frequency of scapular notching and its association with functional outcomes following reverse shoulder arthroplasty (RSA).
Materials and
Methods: This retrospective study included 83 patients with a minimum follow-up of 36 months who underwent RSA at a tertiary care center between 2010 and 2019. Radiographs were evaluated for scapular notching according to the Sirveaux classification. Clinical outcome assessment was based on pre- and post-operative results with the University of California–Los Angeles [UCLA] score and the American Shoulder and Elbow Surgeons (ASES) score, while pain was evaluated with the Visual Analog Scale (VAS). Patients were classified for the presence or absence of scapular notching.

Results: Scapular notching was detected in 46 patients (55.4%). All patients demonstrated significant post-operative improvement in UCLA, ASES, and VAS scores (p<0.001). However, patients without notching had significantly higher post-operative UCLA (27 vs. 25, p=0.027) and ASES scores (82 vs. 72, p=0.007) compared to those with notching. The magnitude of improvement (score change) in UCLA was also greater in the non-notching group (22 vs. 17, p<0.001). The groups were similar in terms of post-operative VAS scores and the decline in pain.

Conclusion: Scapular notching is a common complication following RSA and, despite overall clinical improvement, is associated with less favorable functional outcomes compared with patients without notching.