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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Augmented glenoid component for bone deficiency in shoulder arthroplasty.
Robert S Rice1, John W Sperling, Joseph Miletti
1Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Clinical Orthopaedics and Related Research
|January 16, 2008
Summary
Total shoulder arthroplasty using a posterior augmented glenoid component provided satisfactory pain relief and improved function for osteoarthritis patients. However, this technique did not always correct instability, and its benefits were marginal.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Degenerative glenohumeral arthritis often causes asymmetric posterior glenoid wear.
- This condition necessitates specific surgical techniques during total shoulder arthroplasty.
Purpose of the Study:
- To evaluate the midterm clinical and radiographic outcomes of using a posterior augmented glenoid component.
- To assess complications and the need for revision surgery in patients with posterior glenoid bone deficiency.
Main Methods:
- A cohort of 13 patients (14 shoulders) with advanced osteoarthritis and posterior glenoid bone deficiency underwent shoulder arthroplasty with an augmented glenoid component between 1995 and 1999.
- Follow-up ranged from 2 to 8 years (mean, 5 years).
- Clinical outcomes were assessed using the modified Neer result rating system, measuring active elevation and external rotation.
Main Results:
- 36% of patients achieved excellent results, 50% satisfactory, and 14% unsatisfactory.
- Mean active elevation improved to 160 degrees, and external rotation to 56 degrees.
- While pain relief and functional improvement were noted, glenoid instability was not consistently corrected.
Conclusions:
- Total shoulder arthroplasty with an asymmetric glenoid component can offer mid-term pain relief and functional gains for osteoarthritis.
- The component's advantage appears marginal, and its clinical utility for instability correction is limited.
- The use of this specific augmented component has been discontinued due to its limited benefits.
