Total reverse arthroplasty of the shoulder and structural bone graft in glenoid defects: Short-term results

To evaluate the clinical and radiological results of a series of patients with a glenoid bone defect treated by reverse total shoulder arthroplasty associated with a bone graft stabilized with a trabecular titanium glenoid component (Axioma SMR Lima®).

Retrospective descriptive study of 16 consecutive patients with an average age of 68.2years. In 13 cases they were primary arthroplasties and in 3 revision ones. The data included in the study were obtained by reviewing the clinical history. The glenoid defect was classified according to Gupta et al. The pre- and postoperative clinical assessment included the score on the visual analogue pain scale (VAS), the result of the Constant score and the active joint balance. Radiographically, the integration of the bone graft and the fixation of the components were assessed.

The average follow-up was 42.1months. The average VAS score improved from 7.5 preoperative points to 2.5 points in the last control (P=.006) and on the Constant score from 35.8 pre-surgical points to 64.4 points (P=.001). The average joint balance went from 54° of abduction, 54° of antepulsion, 24° of external rotation and internal rotation to preoperative trochanter to 120° of abduction (P=.001), 124° of antepulsion (P=.001), 63° of external rotation (P=0.001) and internal rotation at L5 in the last clinical control. In all patients, graft integration and the absence of component loosening were observed. The incidence of complications was 6.2%.

The treatment of glenoid defects by reverse total shoulder arthroplasty and a bone graft stabilized by trabecular titanium metaglene presents good clinical and radiological results and a low rate of short-term complications.