Rice, Robert S. (2008) — Augmented glenoid component for bone deficiency in shoulder arthroplasty

Augmented Glenoid Component for Bone Deficiency in Shoulder Arthroplasty

·Clin Orthop Relat Res·2008·138 citations·Shoulder & Elbow

This Mayo Clinic retrospective study examines midterm clinical and radiographic outcomes of a posterior augmented polyethylene glenoid component—designed to correct posterior glenoid bone deficiency in osteoarthritis—in 13 patients (14 shoulders) followed for a mean of 5 years after total shoulder arthroplasty.

Study Snapshot

Design

Retrospective case series

Setting: Single center, Mayo Clinic Rochester

Objective

Whether posterior augmented glenoid component yields satisfactory outcomes in posterior glenoid bone deficiency

Outcome(s)

Clinical and radiographic outcome, complications, revision rate at mean 5 years

Subjects

13 patients (14 shoulders), posterior glenoid deficiency

Posterior augmented keeled all-polyethylene cemented glenoid component

Inclusion

Glenohumeral arthritis with posterior glenoid deficiency
Failed nonoperative treatment
Minimum 2-year followup

Follow-up

Mean 5 years (range 2–8)

Statistics

Paired t-test

Key Findings

Pain improved significantly: mean pain score dropped from 4.3 to 2.1 (p = 0.0001) and mean active abduction improved from 99° to 160° (p = 0.0001)
By modified Neer criteria 36% excellent, 50% satisfactory, 14% unsatisfactory — both unsatisfactory results were due to persistent moderate pain
Instability was not reliably corrected: 4 of 12 radiographically evaluable shoulders had more than mild subluxation at follow-up, including one severe anterior dislocation in a patient with Parkinsonism
Only 1 shoulder developed a radiographically loose glenoid component (Grade 5 periprosthetic lucency with component shift); no revisions were performed
The authors concluded the augmented component's advantage was marginal compared to soft-tissue balancing alone, and discontinued its use

Clinical Relevance

When planning TSA for a patient with posterior glenoid bone deficiency and subluxation, recognize that neither an augmented component nor bone grafting reliably corrects instability on its own — meticulous soft-tissue balancing (capsular release, subscapularis advancement, appropriate humeral head sizing) is the critical variable, and version correction alone does not guarantee re-centering.

Supplemental

Augmented Glenoid Component for Bone Deficiency in Shoulder Arthroplasty

Rice, Cofield, et al.·Clin Orthop Relat Res·2008·138 citations·Shoulder & Elbow

Augmented Glenoid Component for Bone Deficiency in Shoulder Arthroplasty

Study Snapshot

Key Findings

Clinical Relevance

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Augmented Glenoid Component for Bone Deficiency in Shoulder Arthroplasty

Study Snapshot

Key Findings

Clinical Relevance

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Augmented Glenoid Component for Bone Deficiency in Shoulder Arthroplasty

Study Snapshot

Key Findings

Clinical Relevance

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Augmented Glenoid Component for Bone Deficiency in Shoulder Arthroplasty

Study Snapshot

Key Findings

Clinical Relevance

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