Retrospective case series from Gerber et al. examining whether corrective eccentric glenoid reaming during TSA re-centers the glenohumeral joint in osteoarthritic shoulders with static posterior humeral head subluxation (PSH, defined as subluxation index ≥65% on CT). The study tests whether glenoid version correction is the operative mechanism of recentering and whether significant PSH should preclude glenoid replacement.
When you see posterior humeral head subluxation on preoperative CT in an arthritic shoulder, don't avoid glenoid replacement — PSH is correctable in ~90% of cases with standard TSA technique including anterior soft tissue release, and functional outcomes are excellent.
The key teaching: don't assume the subluxation will self-correct simply by reaming the glenoid into neutral version; the soft tissue release component appears equally or more important, and the exact mechanism of recentering remains incompletely understood.
Retrospective case series from Gerber et al. examining whether corrective eccentric glenoid reaming during TSA re-centers the glenohumeral joint in osteoarthritic shoulders with static posterior humeral head subluxation (PSH, defined as subluxation index ≥65% on CT). The study tests whether glenoid version correction is the operative mechanism of recentering and whether significant PSH should preclude glenoid replacement.
When you see posterior humeral head subluxation on preoperative CT in an arthritic shoulder, don't avoid glenoid replacement — PSH is correctable in ~90% of cases with standard TSA technique including anterior soft tissue release, and functional outcomes are excellent.
The key teaching: don't assume the subluxation will self-correct simply by reaming the glenoid into neutral version; the soft tissue release component appears equally or more important, and the exact mechanism of recentering remains incompletely understood.