Ashish Gupta1, Christoph Thussbas2, Michael Koch2, Ludwig Seebauer2. 1. Klinikum Bogenhausen, Munich, Germany; Greenslopes Hospital, Brisbane, QLD, Australia. Electronic address: ashish@drashishgupta.com.au. 2. Klinikum Bogenhausen, Munich, Germany.
Abstract
BACKGROUND: Management of significant glenoid bone loss in patients undergoing a reverse shoulder arthroplasty (RSA) poses a significant treatment challenge. The long-term outcome of single-stage RSA with glenoid bone grafting is unknown. This study assesses the indications, technique, and outcome of RSA with glenoid bone grafting. MATERIALS AND METHODS: Between 2001 and 2010, there were 1074 RSAs performed at our institution; 94 patients had significant glenoid bone loss. Each glenoid defect was subclassified as centric or eccentric and graded 1-4. The patients underwent a single-stage or 2-stage RSA with glenoid bone grafting. A retrospective analysis of the preoperative and postoperative clinical and radiologic outcome was carried out. The mean follow-up was 2.4 years (0.52-10.7 years). RESULTS: Of these patients, 17% had a centric defect and 83% had an eccentric glenoid defect. Composite glenoid grafts were required in 12 patients, 9 of whom required a glenoid baseplate with a long central peg; 92.5% (87/94) of the patients could be managed with a single-stage procedure. Improvement in the Constant score of 61 points (17.9 to 78.9; P < .01) and the mean Simple Shoulder Test score of 5.8 points (1.6 to 7.5; P < .001) was noted. No correlation was found between the clinical outcome and indication for surgery, age, location of defect, and size of defect. CONCLUSION: Severe glenoid bone loss can usually be managed by a single-stage bone graft and RSA. A 2-stage procedure is recommended when primary baseplate stability is not attainable.
BACKGROUND: Management of significant glenoid bone loss in patients undergoing a reverse shoulder arthroplasty (RSA) poses a significant treatment challenge. The long-term outcome of single-stage RSA with glenoid bone grafting is unknown. This study assesses the indications, technique, and outcome of RSA with glenoid bone grafting. MATERIALS AND METHODS: Between 2001 and 2010, there were 1074 RSAs performed at our institution; 94 patients had significant glenoid bone loss. Each glenoid defect was subclassified as centric or eccentric and graded 1-4. The patients underwent a single-stage or 2-stage RSA with glenoid bone grafting. A retrospective analysis of the preoperative and postoperative clinical and radiologic outcome was carried out. The mean follow-up was 2.4 years (0.52-10.7 years). RESULTS: Of these patients, 17% had a centric defect and 83% had an eccentric glenoid defect. Composite glenoid grafts were required in 12 patients, 9 of whom required a glenoid baseplate with a long central peg; 92.5% (87/94) of the patients could be managed with a single-stage procedure. Improvement in the Constant score of 61 points (17.9 to 78.9; P < .01) and the mean Simple Shoulder Test score of 5.8 points (1.6 to 7.5; P < .001) was noted. No correlation was found between the clinical outcome and indication for surgery, age, location of defect, and size of defect. CONCLUSION: Severe glenoid bone loss can usually be managed by a single-stage bone graft and RSA. A 2-stage procedure is recommended when primary baseplate stability is not attainable.
Authors: Sarav S Shah; Benjamin T Gaal; Alexander M Roche; Surena Namdari; Brian M Grawe; Macy Lawler; Stewart Dalton; Joseph J King; Joshua Helmkamp; Grant E Garrigues; Thomas W Wright; Bradley S Schoch; Kyle Flik; Randall J Otto; Richard Jones; Andrew Jawa; Peter McCann; Joseph Abboud; Gabe Horneff; Glen Ross; Richard Friedman; Eric T Ricchetti; Douglas Boardman; Robert Z Tashjian; Lawrence V Gulotta Journal: JSES Int Date: 2020-09-07
Authors: Sarav S Shah; Alexander M Roche; Spencer W Sullivan; Benjamin T Gaal; Stewart Dalton; Arjun Sharma; Joseph J King; Brian M Grawe; Surena Namdari; Macy Lawler; Joshua Helmkamp; Grant E Garrigues; Thomas W Wright; Bradley S Schoch; Kyle Flik; Randall J Otto; Richard Jones; Andrew Jawa; Peter McCann; Joseph Abboud; Gabe Horneff; Glen Ross; Richard Friedman; Eric T Ricchetti; Douglas Boardman; Robert Z Tashjian; Lawrence V Gulotta Journal: JSES Int Date: 2020-09-10