Clinical and Radiographic Outcomes and Graft Incorporation Rate Assessed by CT Scan After Reverse Shoulder...

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Radiology

Background:

• Structural bone grafting is a technique for addressing glenoid bony defects in reverse total shoulder arthroplasty (RTSA).
• Previous studies show acceptable outcomes but often lack detailed graft incorporation analysis via CT scans.
• This study aims to evaluate clinical and radiographic outcomes, including CT-assessed graft incorporation, after RTSA with structural bone grafts.

Purpose of the Study:

• To assess clinical and radiographic outcomes of RTSA with structural bone graft for glenoid reconstruction.
• To evaluate bone graft incorporation using CT scans at least one year postoperatively.
• To determine the reliability of autograft and allograft in primary and revision RTSA settings.

Main Methods:

• A retrospective review of 35 patients and a prospective enrollment of 32 patients undergoing RTSA with structural bone graft.
• Preoperative and postoperative clinical scores (ASESS and VAS) and radiographs were collected.
• Postoperative CT scans were obtained at least 1 year after surgery to assess graft incorporation.

Main Results:

• A total of 67 patients (35 retrospective, 32 prospective) were included, with autograft used in 68.7% and allograft in 21%.
• Mean ASESS scores significantly improved from 33.1 to 78.2 (P < 0.0001).
• CT scans showed complete graft incorporation in 90% of cases, with 94% of RTSA constructs remaining stable.

Conclusions:

• RTSA with structural bone autograft or allograft is a dependable method for glenoid augmentation in both primary and revision shoulder arthroplasty.
• High rates of bony incorporation for both graft types, as confirmed by CT, support the reliability of this technique.