Severe Glenoid Erosion (B2, B3, C, E2, E3) Treated with RSA

2019 ◽  
pp. 59-73
Author(s):  
Francesco Ascione ◽  
Howard D. Routman
Keyword(s):  
Glenoid Erosion

scholarly journals Total versus hemiarthroplasty for glenohumeral arthritis according to preoperative glenoid erosion

2015 ◽  
Vol 7 (2) ◽  
Author(s):  
Marc-Frederic Pastor ◽  
Melena Kaufmann ◽  
Andre Gettmann ◽  
Mathias Wellmann ◽  
Tomas Smith
Keyword(s):  
Pain Relief ◽  
Clinical Outcome ◽  
Internal Rotation ◽  
Constant Score ◽  
Total Shoulder Arthroplasty ◽  
Short Term ◽  
Simple Shoulder Test ◽  
Lower Pain ◽  
Glenoid Erosion

Clinical studies on primary osteoarthritis have shown better results of total shoulder arthroplasty (TSA) compared to hemiarthroplasty (HA) regarding the function, revision rate and postoperative pain relief. However, a clear recommendation for implantation of TSA or HA, depending on the glenoid type of erosion, does not exist. The aim of the study was to compare the results of TSA and HA with respect to the preoperative glenoid type. In this study, 41 patients were examined retrospectively; among them, 25 patients were treated with stemmed anatomic TSA and 16 with stemmed anatomic HA. The degree of osteoarthritis was determined according to Samilson and the glenoid erosion was classified according to Walch. The clinical outcome of the patients was determined by using the Constant Score (CS) and the Simple Shoulder Test at final follow-up. Patients after TSA demonstrated a significantly improved internal rotation compared to HA patients. Patients with preoperative B1 glenoid showed better pain relief after TSA compared to HA. For patients with preoperative type A2 glenoid a significantly higher CS was found after TSA compared to HA. We were able to show good short-term results after TSA and HA. Our findings suggest a better internal rotation for TSA compared to HA, superior clinical outcome for patients with preoperative A2 glenoid and lower pain level for patients with a preoperative B1 glenoid. However, these results need to be confirmed by further studies.

scholarly journals Changes of Bipolar Bone Defect Size After Arthroscopic Bankart Repair for Traumatic Anterior Shoulder Instability: Evaluation Using a Scoring System and Influence on Postoperative Recurrence

2019 ◽  
Vol 7 (11) ◽  
pp. 232596711988534
Author(s):  
Shigeto Nakagawa ◽  
Ryohei Uchida ◽  
Hiroyuki Yokoi ◽  
Wataru Sahara ◽  
Tatsuo Mae
Keyword(s):  
Recurrence Rate ◽  
Bone Defect ◽  
Bone Defects ◽  
Postoperative Recurrence ◽  
Defect Size ◽  
Bone Union ◽  
Bankart Repair ◽  
Glenoid Defect ◽  
Arthroscopic Bankart Repair ◽  
Glenoid Erosion

Background: The combination of a glenoid defect and a Hill-Sachs lesion in shoulders with traumatic anterior instability has been termed bipolar bone loss, and the preoperative size of these lesions has been reported to influence postoperative recurrence of instability after arthroscopic Bankart repair. Purpose: To investigate the influence of postoperative bipolar bone defect size on postoperative recurrence of instability. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 64 male collision/contact athletes (69 shoulders) were evaluated for a minimum of 2 years after surgery, and the pre- and postoperative sizes of both lesions (glenoid defect and Hill-Sachs) were evaluated retrospectively with 3-dimensional computed tomography. The sports played by the athletes included rugby (n = 28 shoulders), American football (n = 24 shoulders), and other collision/contact sports (n = 17 shoulders). Glenoid defects and Hill-Sachs lesions were classified into 5 size categories and assigned scores from 0 (no defect) to 4 (very large defect). Patients were then classified according to the total score (sum of the scores for both lesions). The influence of pre- and postoperative bipolar bone defect sizes on recurrence of instability was investigated by using the total scores for bipolar bone defects. The influence of postoperative glenoid morphology (normal preoperative glenoid, preoperative glenoid erosion, bone union after arthroscopic bony Bankart repair [ABBR], or nonunion after ABBR) was also investigated, as well as changes in shoulders with a preoperative off-track Hill-Sachs lesion. Results: Of 69 shoulders, 15 (21.7%) developed recurrent instability after surgery. The postoperative recurrence rate was 0% in shoulders with a total score ≤1, while the recurrence rate was consistently higher in shoulders with a total score ≥2 at both pre- and postoperative evaluation (mean, 28.8% and 32.6%, respectively). Postoperative recurrence was uncommon when there was a normal preoperative glenoid or bone union after ABBR, while it was frequent in shoulders with preoperative glenoid erosion or shoulders with nonunion after ABBR and a total score ≥2. An off-track lesion was recognized in 9 shoulders preoperatively. It was transformed to on-track lesions in 4 of the 5 shoulders showing bone union after ABBR, and there was no recurrence in the 5 shoulders with bone union. In contrast, postoperative recurrence of instability occurred in 3 of the 4 shoulders without bone union. Conclusion: Postoperative recurrence was influenced by the pre- and postoperative size of bipolar bone defects. Recurrence was uncommon if bone union was achieved after ABBR, even if there had been an off-track lesion preoperatively.

Preoperative three-dimensional computer planning for reverse total shoulder arthroplasty and bone grafting for severe glenoid deformity

2020 ◽  
pp. 175857322090890
Author(s):  
Robert Z Tashjian ◽  
Lindsay Beck ◽  
Irene Stertz ◽  
Peter N Chalmers
Keyword(s):  
Shoulder Arthroplasty ◽  
Bone Grafting ◽  
Total Shoulder Arthroplasty ◽  
Three Dimensional ◽  
Reverse Total Shoulder Arthroplasty ◽  
Patient Specific ◽  
Computer Assisted ◽  
Patient Specific Instrumentation ◽  
Reverse Total Shoulder ◽  
Glenoid Erosion

Background Computer assisted planning without patient specific instrumentation may be utilized to guide reverse total shoulder arthroplasty baseplate placement. The purpose of this study was to determine the difference between planned and achieved inclination and retroversion correction with three-dimensional preoperative computer assisted planning in reverse total shoulder arthroplasty without patient specific instrumentation with bone grafting for severe glenoid erosion. Methods Preoperative three-dimensional computer assisted planning without patient specific instrumentation was performed on 15 patients undergoing primary reverse total shoulder arthroplasty with glenoid bone grafting for severe glenoid erosion. On preoperative and immediate postoperative computed tomography slices, two-dimensional retroversion and inclination were measured. Preoperative three-dimensional baseline retroversion and inclination and planned postoperative three-dimensional retroversion and inclination were measured. Planned and achieved version and inclination changes were compared. Results The planned and achieved retroversion corrections were 18° and 12°, respectively (p < 0.001). The planned and achieved inclination corrections were 11° and 11°, respectively (p = 0.803). Conclusions Three-dimensional computer assisted planning without patient specific instrumentation in the setting of reverse total shoulder arthroplasty with severe glenoid erosion requiring bone grafting can accurately guide baseplate placement. All cases in which failure to correct retroversion or inclination within 10° of planning occurred in patients with severe erosion (B3 or E3 glenoids), therefore patient specific guides may be warranted in these cases to improve accuracy of implantation. Level of evidence Level IV, retrospective case series.

Effect of Glenoid Implant Orientation and Depth on Potential Cement Failure in Total Shoulder Arthroplasty Using Finite Element Analysis

2012 ◽  
Author(s):  
Charlie Yongpravat ◽  
William N. Levine ◽  
Louis U. Bigliani ◽  
Thomas R. Gardner ◽  
Christopher S. Ahmad
Keyword(s):  
Finite Element Analysis ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Cement Mantle ◽  
Glenoid Component ◽  
Fixation Failure ◽  
Element Analysis ◽  
Component Loosening ◽  
Glenoid Erosion ◽  
Glenoid Retroversion

One of the most common complications of total shoulder arthroplasty (TSA) is glenoid component loosening due to implant-cement fixation failure. High cement stresses resulting in fracture are believed to result from malpositioning the glenoid implant [1]. Ideal glenoid preparation and placement, however, are not always achievable due to significant anatomical alterations caused by arthritis resulting in posterior glenoid erosion and increased glenoid retroversion. To our knowledge, prior research has not compared the effects of insufficient reaming depth and incomplete version correction on the likelihood of cement mantle failure. The purpose of this study was to investigate how the degree of correction of the glenoid vault affects cement mantle stress and potential cement failure.

scholarly journals CT measurement of glenoid erosion in arthritis

1994 ◽  
Vol 76-B (3) ◽  
pp. 384-388 ◽  
Author(s):  
AB Mullaji ◽  
FH Beddow ◽  
GH Lamb
Keyword(s):  
Glenoid Erosion ◽  
Ct Measurement

Surgical Management of Glenohumeral Osteoarthritis With Glenoid Erosion and Static Posterior Subluxation (Walch B2): Techniques, Outcomes, and Survivorship Rates

Orthopedics ◽  
2020 ◽  
Vol 43 (4) ◽  
pp. e191-e201
Author(s):  
Ajaykumar Shanmugaraj ◽  
Mohamed Sarraj ◽  
Ryan P. Coughlin ◽  
Evan M. Guerrero ◽  
Seper Ekhtiari ◽  
...  
Keyword(s):  
Surgical Management ◽  
Posterior Subluxation ◽  
Glenohumeral Osteoarthritis ◽  
Glenoid Erosion

Glenoid Erosion Leading to Contact with Retained Metallic Suture Anchors: Bilateral Metallosis After Bilateral Shoulder Hemiarthroplasty

2017 ◽  
Vol 7 (2) ◽  
pp. e24-e24
Author(s):  
Justin J. Mitchell ◽  
Dimitri S. Tahal ◽  
J. Christoph Katthagen ◽  
Alexander R. Vap ◽  
Peter J. Millett
Keyword(s):  
Suture Anchors ◽  
Shoulder Hemiarthroplasty ◽  
Glenoid Erosion

Open Reconstruction of Large Bony Glenoid Erosion with Allogeneic Bone Graft for Recurrent Anterior Shoulder Dislocation

2009 ◽  
Vol 37 (9) ◽  
pp. 1792-1797 ◽  
Author(s):  
Pei-Wei Weng ◽  
Hsain-Chung Shen ◽  
Hsieh-Hsing Lee ◽  
Shing-Sheng Wu ◽  
Chian-Her Lee
Keyword(s):  
Case Series ◽  
Anterior Shoulder Instability ◽  
Bony Union ◽  
Allogeneic Bone ◽  
Glenohumeral Instability ◽  
Capsular Shift ◽  
Open Reconstruction ◽  
The Mean ◽  
Anterior Glenohumeral Instability ◽  
Glenoid Erosion

Background Severe glenoid bone loss in recurrent anterior glenohumeral instability is rare and difficult to treat. Purpose The authors present a surgical technique using allogeneic bone grafting for open anatomic glenoid reconstruction in addition to the capsular shift procedure. Study Design Case series; Level of evidence, 4. Methods Nine consecutive patients with a history of recurrent anterior shoulder instability underwent reconstruction of large bony glenoid erosion with a femoral head allograft combined with an anteroinferior capsular shift procedure. Preoperative computed tomographic and arthroscopic evaluation was performed to confirm a ≥120° osseous defect of the anteroinferior quadrant of the glenoid cavity, which had an “inverted-pear” appearance. Patients were followed for at least 4.5 years (range, 4.5-14). Serial postoperative radiographs were evaluated. Functional outcomes were assessed using Rowe scores. Results All grafts showed bony union within 6 months after surgery. The mean Rowe score improved to 84 from a preoperative score of 24. The mean loss of external rotation was 7° compared with the normal shoulder. One subluxation and 1 dislocation occurred after grand mal seizures during follow-up. These 2 patients regained shoulder stability after closed reduction. The remaining patients did not report recurrent instability. All patients resumed daily activities without restricted motion. Conclusion This technique for open reconstruction is viable for the treatment of recurrent anterior glenohumeral instability with large bony glenoid erosion.

Glenoid erosion is a risk factor for recurrent instability after Hill-Sachs remplissage

2021 ◽  
Vol 103-B (4) ◽  
pp. 718-724
Author(s):  
Maxime Cavalier ◽  
Tyler Robert Johnston ◽  
Laurie Tran ◽  
Marc-Olivier Gauci ◽  
Pascal Boileau
Keyword(s):  
High Risk ◽  
Bone Loss ◽  
Return To Sport ◽  
Glenoid Bone Loss ◽  
Secondary Outcome ◽  
Recurrent Instability ◽  
Group A ◽  
Group B ◽  
Glenoid Erosion

Aims The aim of this study was to identify risk factors for recurrent instability of the shoulder and assess the ability to return to sport in patients with engaging Hill-Sachs lesions treated with arthroscopic Bankart repair and Hill-Sachs remplissage (ABR-HSR). Methods This retrospective study included 133 consecutive patients with a mean age of 30 years (14 to 69) who underwent ABR-HSR; 103 (77%) practiced sports before the instability of the shoulder. All had large/deep, engaging Hill-Sachs lesions (Calandra III). Patients were divided into two groups: A (n = 102) with minimal or no (< 10%) glenoid bone loss, and B (n = 31) with subcritical (10% to 20%) glenoid loss. A total of 19 patients (14%) had undergone a previous stabilization, which failed. The primary endpoint was recurrent instability, with a secondary outcome of the ability to return to sport. Results At a mean follow-up of four years (1.0 to 8.25), ten patients (7.5%) had recurrent instability. Patients in group B had a significantly higher recurrence rate than those in group A (p = 0.001). Using a multivariate logistic regression, the presence of glenoid erosion of > 10% (odds ratio (OR) = 35.13 (95% confidence interval (CI) 8 to 149); p = 0.001) and age < 23 years (OR = 0.89 (0.79 to 0.99); p = 0.038) were associated with a higher risk of recurrent instability. A total of 80 patients (78%) could return to sport, but only 11 athletes (65%) who practiced high-risk (collision or contact-overhead) sports. All seven shoulders which were revised using a Latarjet procedure were stable at a mean final follow-up of 36 months (11 to 57) and returned to sports at the same level. Conclusion Patients with subcritical glenoid bone loss (> 10%) and younger age (≤ 23 years) are at risk of failure and reoperation after ABR-HSR. Furthermore, following this procedure, one-third of athletes practicing high-risk sports are unable to return at their pre-instability level, despite having a stable shoulder. Cite this article: Bone Joint J 2021;103-B(4):718–724.

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