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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
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A Sequential Approach to the Management of Posterior Glenoid Defects in RSA: Angulated BIO Versus Multiple
Shinji Imai1,2
1Shiga University of Medical Science Hospital, Otsu, Shiga, Japan.
JB & JS Open Access
|October 27, 2021
Summary
This study presents a sequential approach for managing posterior glenoid defects in reverse shoulder arthroplasty (RSA). Different techniques, including bone-grafting, effectively addressed varying degrees of glenoid retroversion, yielding acceptable outcomes.
Area of Science:
- Orthopedic surgery
- Shoulder arthroplasty
- Grafting techniques
Background:
- Large posterior glenoid defects present challenges in reverse shoulder arthroplasty (RSA).
- A sequential management approach is crucial for addressing varying degrees of glenoid retroversion.
Purpose of the Study:
- To evaluate a sequential management strategy for posterior glenoid defects in RSA.
- To compare the efficacy of asymmetrical reaming, ring grafting, and multiple bioresorbable pinning (MBP)-assisted bone-grafting.
Main Methods:
- Retrospective review of 52 shoulders with posterior glenoid defects undergoing RSA (2014-2019).
- Group A (<15° retroversion): asymmetrical reaming. Group B (15°-30° retroversion): asymmetrical reaming + angulated ring graft. Group C (≥30° retroversion): MBP-assisted bone-grafting.
- Mean follow-up of 4.8 years.
Main Results:
- Mean version correction: 10.6° (A), 20.7° (B), 33.8° (C).
- Postoperative active anterior elevation: 138.3° (A), 128.3° (B), 126.5° (C).
- Graft incorporation: 89.5% (B), 100% (C). Complications included fractures and transient brachial plexus palsy.
Conclusions:
- The sequential approach for posterior glenoid defects in RSA yielded acceptable results.
- MBP-assisted bone-grafting is effective for severe defects; ring grafting shows promise but requires further follow-up.
