Glenoid bone grafting in reverse shoulder arthroplasty for long-standing anterior shoulder dislocation

Background Primary anatomic total shoulder arthroplasty can be challenging in patients with complex glenoid wear patterns and bone loss. Severe retroversion (>15°) or significant bone loss may require bone grafting. This review summarizes the rate of revision and long-term outcomes of anatomic total shoulder arthroplasty with bone graft. Methods A systematic search of MEDLINE, Embase, PubMed, and CENTRAL databases was conducted from the date of inception to 23 October 2018. Two reviewers independently screened articles for eligibility and extracted data for analysis. The primary outcome was rate of revision. The secondary outcomes were rate of component loosening, functional outcome, and range of motion. Results Of the 1056 articles identified in the search, 26 underwent full-text screening and 7 articles were included in the analysis. All procedures were one-stage anatomic total shoulder arthroplasties. The rate of revision was 5.4% with component loosening and infection listed as indications over a weighted mean follow-up period of 6.3 years. Complications occurred in 12.6% of patients. Conclusion Glenoid bone grafting in anatomic total shoulder arthroplasty results in comparable revision rates and improvement in pain compared to augmented glenoid components and reverse shoulder arthroplasty. Due to the low quality of evidence, further prospective studies should be conducted. Level of evidence IV

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CT evaluation of glenoid joint line restoration with glenoid bone grafting and reverse shoulder arthroplasty in patients with significant glenoid bone loss

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2020.09.031 ◽

2020 ◽

Author(s):

Kristine R. Italia ◽

Nicholas Green ◽

Jashint Maharaj ◽

Marine Launay ◽

Ashish Gupta

Keyword(s):

Bone Loss ◽

Shoulder Arthroplasty ◽

Bone Grafting ◽

Reverse Shoulder Arthroplasty ◽

Joint Line ◽

Glenoid Bone Loss ◽

Ct Evaluation

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Subscapularis insufficiency and the risk of shoulder dislocation after reverse shoulder arthroplasty

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2008.12.013 ◽

2009 ◽

Vol 18 (6) ◽

pp. 892-896 ◽

Cited By ~ 169

Author(s):

T. Bradley Edwards ◽

Matthew D. Williams ◽

Joanne E. Labriola ◽

Hussein A. Elkousy ◽

Gary M. Gartsman ◽

...

Keyword(s):

Shoulder Arthroplasty ◽

Shoulder Dislocation ◽

Reverse Shoulder Arthroplasty

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Shoulder arthroplasty for locked anterior shoulder dislocation: a role for the reversed design

International Orthopaedics ◽

10.1007/s00264-017-3450-1 ◽

2017 ◽

Vol 41 (6) ◽

pp. 1227-1234 ◽

Cited By ~ 14

Author(s):

Joseph M. Statz ◽

Bradley S. Schoch ◽

Joaquin Sanchez-Sotelo ◽

John W. Sperling ◽

Robert H. Cofield

Keyword(s):

Shoulder Arthroplasty ◽

Shoulder Dislocation ◽

Anterior Shoulder Dislocation

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Reverse Shoulder Arthroplasty for B2 Glenoid Deformity

Journal of Shoulder and Elbow Arthroplasty ◽

10.1177/2471549219897661 ◽

2019 ◽

Vol 3 ◽

pp. 247154921989766

Author(s):

Andrew M. Holt ◽

Thomas W. Throckmorton

Keyword(s):

Successful Treatment ◽

Shoulder Arthroplasty ◽

Bone Grafting ◽

Older Patients ◽

Reverse Shoulder Arthroplasty ◽

Joint Line ◽

Shoulder Osteoarthritis ◽

Current Trends

In shoulder osteoarthritis, the B2 glenoid presents challenges in treatment because of the excessive retroversion and posterior deficiency of the glenoid. Correction of retroversion and maintenance of a stable joint line with well-fixed implants are essential for the successful treatment of this deformity with arthroplasty. Reverse shoulder arthroplasty offers several key advantages in achieving this goal, including favorable biomechanics, a well-fixed baseplate, and proven success in other applications. Techniques such as eccentric reaming, bone grafting, and baseplate augmentation allow surgeons to tailor treatment to the patient’s altered anatomy. Eccentric reaming is favored for correction of small defects or mild version anomalies. Current trends favor bone grafting for larger corrections, though augmented components have shown early promise with the potential for expanded use. With overall promising results reported in the literature, reverse shoulder arthroplasty is a useful tool for treating older patients with B2 glenoid deformities.

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