PSH was long thought to be driven primarily by glenoid retroversion, making surgeons hesitant to offer TSA when retroversion was severe. This paper dismantles that assumption directly. Screen every TSA candidate with preoperative CT. PSH is present in more than 1 in 4 patients and is undetectable on plain films.
When you find PSH, plan for the full combination: eccentric glenoid reaming, generous capsulolabral release, and subscapularis mobilization. This package corrects PSH in 91% of cases. Achieving a specific version target is not what does the work.
Heavy preoperative retroversion with poor function is not a contraindication. Proceed with arthroplasty — postoperative version did not predict functional outcomes in this series. The anterior capsular release you perform at every TSA may be the single most important step in re-centering the joint.
PSH was long thought to be driven primarily by glenoid retroversion, making surgeons hesitant to offer TSA when retroversion was severe. This paper dismantles that assumption directly. Screen every TSA candidate with preoperative CT. PSH is present in more than 1 in 4 patients and is undetectable on plain films.
When you find PSH, plan for the full combination: eccentric glenoid reaming, generous capsulolabral release, and subscapularis mobilization. This package corrects PSH in 91% of cases. Achieving a specific version target is not what does the work.
Heavy preoperative retroversion with poor function is not a contraindication. Proceed with arthroplasty — postoperative version did not predict functional outcomes in this series. The anterior capsular release you perform at every TSA may be the single most important step in re-centering the joint.