[Glenoid reconstruction in revision shoulder arthroplasty]

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Reconstructive Surgery

Background:

• Revision shoulder arthroplasty often involves significant glenoid bone loss due to loosening or wear.
• Reconstructing advanced bone stock is crucial for restoring joint stability and function.

Purpose of the Study:

• To describe a surgical technique for stable glenoid baseplate fixation and bone loss reconstruction.
• To correct version, inclination, and medialization of the joint line during revision shoulder arthroplasty.

Main Methods:

• Utilized a transfixation technique with cementless fixation of structural bone grafts and reverse baseplates.
• Employed autografts (iliac crest) and allografts, with metallic augmentation when necessary.
• Followed a modified postoperative protocol involving an abduction brace and exercises.

Main Results:

• A retrospective evaluation of 145 cases with moderate to advanced bone loss showed a success rate over 90% for both one- and two-stage reconstructions.
• High incorporation rates of iliac crest autografts were observed.
• The technique effectively addressed bone defects, with 56 cases requiring iliac crest bone grafts.

Conclusions:

• The described surgical technique provides a reliable method for reconstructing significant glenoid bone loss in revision shoulder arthroplasty.
• The transfixation technique with bone grafts and reverse baseplates demonstrates high success rates and good graft incorporation.
• This approach is comparable to existing literature data for revision shoulder arthroplasty outcomes.