Gupta, J Shoulder Elbow Surg 2018 - Management of Glenoid Bone Defects with Reverse Shoulder Arthroplasty-Surgical Technique and Clinical Outcomes - Article Summary

Management of Glenoid Bone Defects with Reverse Shoulder Arthroplasty-Surgical Technique and Clinical Outcomes

Gupta, Seebauer, et al.·J Shoulder Elbow Surg·2018·95 citations·Case series

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.

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.

Conclusions

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.

Level of evidence: Level IV; Case Series; Treatment Study. Copyright remains with the authors and publisher.

Supplemental

Management of Glenoid Bone Defects with Reverse Shoulder Arthroplasty-Surgical Technique and Clinical Outcomes.

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Management of Glenoid Bone Defects with Reverse Shoulder Arthroplasty-Surgical Technique and Clinical Outcomes

Gupta, Seebauer, et al.·J Shoulder Elbow Surg·2018·95 citations·Case series

DOI·PubMed

Background

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.

Conclusions

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.

Level of evidence: Level IV; Case Series; Treatment Study. Copyright remains with the authors and publisher.

Background

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.

Conclusions

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.

Level of evidence: Level IV; Case Series; Treatment Study. Copyright remains with the authors and publisher.

Background

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.

Conclusions

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.

Level of evidence: Level IV; Case Series; Treatment Study. Copyright remains with the authors and publisher.