The glenoid in total shoulder arthroplasty

Schrumpf, Mark A.; Maak, Travis G.; Hammoud, Sommer; Craig, Edward V.

doi:10.1007/s12178-011-9096-5

Cited by 26 publications

(13 citation statements)

References 84 publications

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Section: Discussionmentioning

confidence: 99%

“…Another concern is the glenoid wear with the hemiarthroplasty, and the glenoid loosening, with total shoulder arthroplasty. If there is instability in the shoulder from a ruptured or nonfunctional cuff, the forces acting in the humeral head implant will be eccentric, resulting in the "rocking horse glenoid" phenomenon that his one of the main causes on glenoid loosening in total shoulder arthroplasty [15].In an attempt to maximize our results we choose to do a reversed shoulder arthroplasty in this patient, achieving good outcome avoiding complications. We believe, based on the literature and on recent advances in the implants and surgical technique, that shoulder reverse arthroplasty will probably achieve better results than unconstrained shoulder implants in treating fixed anterior dislocations in geriatric patients.…”

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confidence: 99%

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Reversed Shoulder Arthroplasty in a Patient with Fixed Anterior Glenohumeral DislocationReversed Shoulder Arthroplasty in a Patient with Fixed Anterior Glenohumeral Dislocation

Marques¹

2016

MOJOR

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An anterior glenohumeral dislocation is a serious condition which can lead to soft tissue damage and substantial defects of the humeral head and glenoid. Little is known about the results of shoulder arthroplasty for the treatment of fixed glenohumeral dislocation. We present a case of an fixed anterior glenohumeral dislocation that developed with no associated trauma in a humeral head with an ongoing avascular necrosis in 75 years old patient with Parkinson disease. The patient had severe pain and a pseudo paralysis of the right arm. Radiology revealed a bone loss of the posterior head. The patient was submitted to a reversed shoulder arthroplasty and at 1 year follow up is happy with no pain; the subjective outcome scores substantially increased and had fair gains in arm mobility with no evidence of instabilities or other complications. We believe, based on the literature, and on recent advances in the implants and surgical technique, that shoulder reverse arthroplasty will probably achieve better results than unconstrained shoulder implants in treating fixed anterior dislocations in geriatric patients. is happy and very satisfied with the surgical outcome, almost with no pain and she is able to do some activities of daily life. On clinical examination ROM is improved with 80º of forward flexion and abduction, internal rotation to gluteus and 15º of external rotation. No signs of instability. The scores improvement was notorious, VAS 3 points, ASES 58 points and SSV 60%. Keywords:Radiological there was an apparently resorption of the glenoid graft but the glenosphere is stable and no scapular notching is observed. DiscussionDislocation of the humeral head in this age can lead to cuff ruptures and posterior head bone loss. This mechanical defect can contribute to permanent dislocation [1,[5][6][7].In our case we managed to obtain a good pain control, VAS score diminished from 9 points to 3 points, fair functional results with 80º of forward flexion and abduction, internal rotation to gluteus and 15º of external rotation. The ASES score improved 53 points to a total of 58 points and SSV score improved from 0% to 60%. The results in pain control and patient satisfaction are very good. Functional results are good but are less good than results of reversed shoulder arthroplasty in arthritis patients [8]. No instability problems were noted at 1 year follow up. One common complication in reversed arthroplasty is instability, but being a constrained implant, has less instability problems than hemi or total shoulder arthroplasty. No scapular notching or progressive radiolucent lines were identified in x-ray, but the glenoid graft had signs of resorption, without evidence of instability of the glenosphere. Boileau et al. reported the use of this bony lateralization reversed shoulder arthroplasty. In their series of 42 patients with 2 years follow up the humeral graft incorporated completely in 98% of cases (41 of 42) and partially in one. At a mean of 28 months postoperatively, no graft resorption, glenoid ...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Reversed Shoulder Arthroplasty in a Patient with Fixed Anterior Glenohumeral DislocationReversed Shoulder Arthroplasty in a Patient with Fixed Anterior Glenohumeral Dislocation

Marques¹

2016

MOJOR

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“…The scapula may be involved in fractures, dislocation, arthritis, tumours and developmental anomalies.The surgical procedures involving scapula include arthroplasty and arthrodesis of glenohumeral joint, acromioplasty for rotator cuff disorders and scapulothoracic tenodesis for winging (6). Indications for shoulder arthroplasty currently include severe proximal humeral fractures, primary glenohumeral osteoarthritis, post traumatic arthritis, shoulder girdle tumors, osteonecrosis and failed shoulder arthroplasty (7).…”

Section: Original Research Articlementioning

confidence: 99%

Osteometric Assessment of Coracoid Process of Scapula-Clinical Implications

Kumar¹,

Kohli²,

Mehta³

et al. 2018

JSA

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The coracoid process is a bony projection arising from the antero-lateral aspect of the scapula. The variation in the height and length of the coracoid process are responsible for altered size and shape of the space between the coracoacromial arch and the rotator cuff. The study was conducted on sixty-four dry adult human scapulae of unknown age and sex with a view to elucidate the morphological and osteometric details. The length of coracoid process on right side was 41.01±3.55 mm and it was found to be 40.88±3.83 mm on left sided. The breadth of coracoid process was observed as 13.93±1.13 mm and 13.25±1.26 mm on right and left side respectively and the difference between the two sides was statistically significant (p=0.026). Thickness of the coracoid process was 8.59±1.32 mm and 8.01±1.16 mm in right and left sided scapulae. The acromiocoracoid distance was found to be 38.48±4.03 mm on right side and 35.51±3.83 mm on left sided scapulae and the difference between to the two sides showed high statistically significance (p=0.004). Mean coracoglenoid distance was noted 26.23±3.05 mm and 24.94±2.75 mm on right and left sided scapulae respectively. Values of the thickness of coracoid process recorded in the present study are at appreciable variance with the result of previous study. The coracoid process constitutes an important component of the scapular glenoid construct and is involved in many surgical interventions on the glenohumeral joint. Comprehension of standard morphometric details of the coracoid process is vital in traumatic cases, surgical interventions and replacement surgeries in the shoulder region.

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“…Neer first developed a contemporary prosthesis for shoulder osteoarthritis in 1974 [1], and since then, shoulder arthroplasty has proven to be an effective method to decrease pain and improve patient function [2•, 3, 4]. The number of shoulder arthroplasties performed from 1993 to 2007 increased by 319 %, with a projected estimated increase of 10.6 % annually [5].…”

Section: Introductionmentioning

confidence: 99%

Porous metals and alternate bearing surfaces in shoulder arthroplasty

Carpenter

Urits

Murthi

2016

Curr Rev Musculoskelet Med

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Total shoulder arthroplasty (TSA) provides an effective solution for the treatment of glenohumeral arthritis. However, long-term outcomes have been limited by glenoid component aseptic loosening and polyethylene (PE) wear. Previous attempts to improve glenoid fixation with metal-backed glenoids resulted in inferior results. Newer component designs that contain porous metal allow for biological ingrowth of the prosthesis, potentially improving longevity and overall outcomes. Porous metal can also improve humeral component fixation, obviating the need for cement and simplifying revision surgery. Advances such as highly cross-linked polyethylene (HXLPE), vitamin E-doped HXLPE, and alternate bearing surfaces like ceramics and pyrolytic carbon have proven to provide superior wear characteristics in other joint replacements and may prove beneficial in the shoulder as well.

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The glenoid in total shoulder arthroplasty

Cited by 26 publications

References 84 publications

Reversed Shoulder Arthroplasty in a Patient with Fixed Anterior Glenohumeral DislocationReversed Shoulder Arthroplasty in a Patient with Fixed Anterior Glenohumeral Dislocation

Reversed Shoulder Arthroplasty in a Patient with Fixed Anterior Glenohumeral DislocationReversed Shoulder Arthroplasty in a Patient with Fixed Anterior Glenohumeral Dislocation

Osteometric Assessment of Coracoid Process of Scapula-Clinical Implications

Porous metals and alternate bearing surfaces in shoulder arthroplasty

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