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Posterior approach shoulder arthroplasty: a cadaveric study assessing access.

R Michael Greiwe1, Sarah A Witzig2, Brandon J Kohrs1

  • 1OrthoCincy Orthopaedics & Sports Medicine, St. Elizabeth Healthcare, The Orthopaedic Research & Innovation Foundation, Inc., Edgewood, KY, USA.

Journal of Shoulder and Elbow Surgery
|November 22, 2020
PubMed
Summary

This cadaveric study found the posterior approach feasible for shoulder replacement, providing excellent access to the glenoid and humerus for arthroplasty. Further clinical research is recommended for posterior shoulder arthroplasty outcomes.

Keywords:
Posterior approach total shoulder arthroplastyaccesscadaver studyglenoid exposurehumeral component placementrotator cuff–sparing shoulder arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Anatomy
  • Surgical Techniques

Background:

  • Posterior shoulder arthroplasty is an alternative surgical approach for shoulder replacement.
  • Assessing the anatomic feasibility of this approach is crucial for its clinical application.

Purpose of the Study:

  • To determine the anatomic feasibility of posterior approach shoulder arthroplasty.
  • To evaluate access to the glenoid, humerus, and canal via the posterior approach.

Main Methods:

  • A cadaveric study using twelve fresh frozen shoulders.
  • Traditional exposure techniques and digital imaging software were employed.
  • Evaluation of direct access to glenoid and humerus, and assessment of stemmed arthroplasty placement.

Main Results:

  • The posterior approach provided 88.8% ± 8.1% direct access to the glenoid.
  • Full access to the center of the humeral head cut surface was achieved in all specimens.
  • Average access to the humerus was 95.3% ± 13.4%, with minimal angulation during stem placement.

Conclusions:

  • The posterior approach allows for adequate access to the glenoid and humerus for shoulder arthroplasty.
  • Further clinical studies are necessary to establish the mid- and long-term efficacy and safety of posterior shoulder arthroplasty.