Effects of Acquired Glenoid Bone Defects on Surgical Technique and Clinical Outcomes in Reverse Shoulder Arthroplasty

Klein, Stephen M.; Dunning, Page; Mulieri, Philip J.; Pupello, Derek; Downes, Katheryne; Frankle, Mark A.

doi:10.2106/jbjs.i.00778

Cited by 190 publications

(110 citation statements)

References 21 publications

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“…19,20,25,37,43,47,49,50,70 Several techniques have been described to reconstruct severe bone loss of the glenoid, including staged revisions as well as the use of autografts and allografts. 1,2,4,7,12,13,19,41,52,53,54,55,68 All techniques have their inherent drawbacks, however, and no ideal approach to reconstruct severely deficient glenoids has so far been identified.…”

mentioning

confidence: 99%

Reconstruction of massive uncontained glenoid defects using a combined autograft-allograft construct with reverse shoulder arthroplasty: preliminary results

Bateman

Donald

2012

Journal of Shoulder and Elbow Surgery

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mentioning

confidence: 99%

Reconstruction of massive uncontained glenoid defects using a combined autograft-allograft construct with reverse shoulder arthroplasty: preliminary results

Bateman

Donald

2012

Journal of Shoulder and Elbow Surgery

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“…Studies included in our review showed an overall mean improvement in ASES scores of 51.6 points (from 27.5 to 79.1), which, although not directly comparable, is greater than the improvement reported in RSA performed for cuff arthropathy (40.75) [46][47][48][49].…”

Section: Discussionmentioning

confidence: 49%

Reverse Shoulder Arthroplasty in Rheumatoid Arthritis: A Systematic Review

Gee¹,

Hanson²,

Saithna³

et al. 2015

Open Orthopaedics J

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Abstract:Background: Anatomical shoulder replacement for rheumatoid arthritis (RA) is complicated by a high incidence of rotator cuff tears and glenoid erosion. This can lead to poor function and early failure. Reverse shoulder arthroplasty (RSA) has gained popularity as an alternative. This systematic review attempts to further define the role of RSA in RA.Methods: A systematic review identified seven studies reporting outcomes of RSA in RA patients. Studies were critically appraised, and data on outcomes, complications and technical considerations were extracted and analysed.Results: One hundred and twenty one shoulders were included (mean follow up 46.9 months). Consistent improvements in the main outcome measures were noted between studies. Ninety five percent of patients described excellent to satisfactory outcomes. The minimum mean forward elevation reported in each study was 115 degrees. Symptomatic glenoid loosening (1.7%), deep infection (3.3%) and revision surgery (5%) rates were no higher than for a population of mixed aetiologies.Discussion: Previous concerns regarding high pre-and peri-operative complication and revision rates in RA patients were not shown to be valid by the results of this review. Although associated cuff tears are common and glenoid bone loss can increase the technical complexity of surgery, RSA provides consistent and predictable improvements in key outcome measures and the revision and complication rates do not appear to be higher than reported in a large population of mixed aetiologies. Conclusion:The contemporary literature shows that RSA is a safe, effective and reliable treatment option in RA patients.

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“…Baseplate malposition can occur very easily in these cases especially in cases that require large structural bone grafts to augment regions of eroded bone. Identification of an alternative centerline with the central post or screw directed towards the scapular spine is a method to improve baseplate fixation as well in cases of bone loss, but determination of this line intraoperatively can be challenging [36]. All of these potential complications encourage the surgeon to pursue all means necessary for safe and effective placement of the glenoid component in both standard and reverse total shoulder arthroplasty.…”

Section: Common Failure Mechanisms Of and Difficulties In Shoulder Armentioning

confidence: 99%

Planning software and patient-specific instruments in shoulder arthroplasty

Wylie

Tashjian

2016

Curr Rev Musculoskelet Med

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Computer planning software and patient-specific instrumentation have been investigated in multiple subspecialties of orthopedics with mixed results. Shoulder arthroplasty has evolved over the last decade with improvements in implant design and surgical instrumentation. Despite these advances, glenoid positioning in shoulder arthroplasty continues to be a difficult problem. Recent advances in threedimensional imaging techniques and the use of computer planning software may potentially address some of the common difficulties encountered by surgeons. The addition of patient-specific instrumentation and guides provide an option for patients with significant glenoid deformity that may allow improved accuracy of glenoid component implantation compared to using standard instrumentation. Studies have reported improved positioning of the glenoid component in both anatomic and reverse total shoulder arthroplasty with patientspecific instrumentation and guides. More research is needed to determine whether these improvements lead to better patient-reported outcomes or implant survival. In addition, further studies will be needed to address whether this technology is cost effective for large-scale implementation in the orthopedic community.

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Effects of Acquired Glenoid Bone Defects on Surgical Technique and Clinical Outcomes in Reverse Shoulder Arthroplasty

Abstract: Glenoid bone defects, when managed with an alteration of surgical technique, including bone-grafting when indicated, are not a contraindication to reverse total shoulder arthroplasty.

Cited by 190 publications

References 21 publications

Reconstruction of massive uncontained glenoid defects using a combined autograft-allograft construct with reverse shoulder arthroplasty: preliminary results

Reconstruction of massive uncontained glenoid defects using a combined autograft-allograft construct with reverse shoulder arthroplasty: preliminary results

Reverse Shoulder Arthroplasty in Rheumatoid Arthritis: A Systematic Review

Planning software and patient-specific instruments in shoulder arthroplasty

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