Reverse total shoulder in the face of glenoid defects
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Management of glenoid bone defects with reverse shoulder arthroplasty—surgical technique and clinical outcomes
Between 2001 and 2010, these authors found that 94 of 1074 reverse total shoulders had significant glenoid bone loss. Of these patients, 17% had a centric defect
and 83% had an eccentric glenoid defect.
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Between 2001 and 2010, these authors found that 94 of 1074 reverse total shoulders had significant glenoid bone loss. Of these patients, 17% had a centric defect
Composite glenoid grafts were required in 12 patients, 9 of whom required a glenoid baseplate with a long central peg.
92.5% (87/94) of the patients could be managed with a single-stage procedure. If the long central peg did not purchase a minimum of 50% of its length in the native scapula, a single-stage reconstruction was aborted in favor of a 2-stage procedure: the glenoid defect was grafted with a composite graft and fixated using cortical screws as required to attain graft stability. In cases of centric defects, a modular humeral component was used and a hemiarthroplasty performed. In cases in which eccentric defects were reconstructed, a resection arthroplasty was performed. In the authors’ experience, a hemiarthroplasty for an eccentric bone defect led to poor graft incorporation and graft nonunion or resorption.
Comment: The key in such cases is that secure baseplate fixation needs to be achieved before the construct is loaded by completing the reverse total shoulder with a glenosphere and a humeral component.
The reader may also be interested in these posts:
Consultation for those who live a distance away from Seattle.
Click here to see the new Shoulder Arthritis Book.
Click here to see the new Rotator Cuff Book
Information about shoulder exercises can be found at this link.
Use the "Search" box to the right to find other topics of interest to you.
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
See from which cities our patients come.
See the countries from which our readers come on this post.
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