Abnormal glenoid architecture resulting from loss of bone usually is listed among the contraindications to total shoulder arthroplasty using an unconstrained prosthesis. However, in a series of 463 consecutive replacement procedures that were performed between 1973 and 1985, in only 2 patients did the lack of bone make the implantation of a glenoid component impossible. Of the remaining 65 shoulders that had an abnormal glenoid, 20 were successfully treated with a large, internally fixed bone graft or grafts and 45, with smaller bone grafts that were not internally fixed. 19 of the 20 shoulders that had a large graft or grafts were followed for 2 years or more (average, 4.4 years). The clinical results were judged to be excellent in 16 and satisfactory in one, and the desired limited goals were obtained in 2. 2 fixation screws broke and one screw was worn by contact with the humeral component. None of the glenoid components clinically loosened or migrated, and no patient has needed further surgical treatment. Although bone-grafting was necessary in only 20 (4.3 per cent) of the 463 replacement procedures, this procedure provided sufficient osseous support to allow implantation of a component in a severely damaged glenoid.
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Abnormal glenoid architecture resulting from loss of bone usually is listed among the contraindications to total shoulder arthroplasty using an unconstrained prosthesis. However, in a series of 463 consecutive replacement procedures that were performed between 1973 and 1985, in only 2 patients did the lack of bone make the implantation of a glenoid component impossible. Of the remaining 65 shoulders that had an abnormal glenoid, 20 were successfully treated with a large, internally fixed bone graft or grafts and 45, with smaller bone grafts that were not internally fixed. 19 of the 20 shoulders that had a large graft or grafts were followed for 2 years or more (average, 4.4 years). The clinical results were judged to be excellent in 16 and satisfactory in one, and the desired limited goals were obtained in 2. 2 fixation screws broke and one screw was worn by contact with the humeral component. None of the glenoid components clinically loosened or migrated, and no patient has needed further surgical treatment. Although bone-grafting was necessary in only 20 (4.3 per cent) of the 463 replacement procedures, this procedure provided sufficient osseous support to allow implantation of a component in a severely damaged glenoid.
Copyright remains with the authors and publisher.