Full-wedge metallic reconstruction of glenoid bone deficiency in reverse shoulder arthroplasty
- PDF / 883,514 Bytes
- 4 Pages / 595 x 792 pts Page_size
- 43 Downloads / 185 Views
Technical Note Obere Extremität https://doi.org/10.1007/s11678-020-00587-9 Received: 11 May 2020 Accepted: 1 July 2020
David Endell1 · Jan-Philipp Imiolczyk2 · Alexandra Grob1 · Philipp Moroder2 · Markus Scheibel1,2 1 2
Shoulder and Elbow Surgery, Schulthess Clinic Zurich, Zurich, Switzerland Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
© The Author(s) 2020
Full-wedge metallic reconstruction of glenoid bone deficiency in reverse shoulder arthroplasty Video online The online version of this article (https:// doi.org/10.1007/s11678-020-00587-9) contains the video: “Full-wedge metallic reconstruction of glenoid bone deficiency in reverse shoulder arthroplasty”. You will find the video at the end of the article as “Supplementary material.” Video by courtesy of D. Endell and A. Grob, Department of Shoulder and Elbow Surgery, Schulthess Clinic Zurich, Switzerland; J.-P. Imiolczyk and P. Moroder, Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin; M. Scheibel, Department of Shoulder and Elbow Surgery, Schulthess Clinic Zurich, Switzerland, and the Department of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Germany; all rights reserved 2020.
Background Glenoid bone loss creates a challenge in choosing the right operative technique for successful defect correction in reverse shoulder arthroplasty. Currently the following treatment options are available [1–3]: When excessive reaming reaches its limits and cannot be reliably used to treat larger defects or extensive medialization, allogenic and autologous bone graft augmentations can be a valid alternative. Another option is metallic wedge augmentation (. Fig. 1; [3, 4]). There are multiple reasons for glenoid bone loss: Cuff tear arthropathy with superior migration of the humeral head can result in asymmetric glenoid wear, described by Sirveaux et al. as type E2
and E3 [5]. Additionally, primary glenohumeral osteoarthritis can result in posterior wear of the glenoid. Addressing glenoid bone deficiency is essential in type B2 and B3 glenoids according to Walch, due to the biconcave destruction of the articular surface with medialization and retroversion of over 20° [6]. Walch type C glenoids exhibit primary dysplastic deformities of the glenoid with retroversion of more than 25°. Planning software (e.g., Blueprint™, Wright Medical Group, Memphis, TN, USA) using thin-layered computed tomography (CT) with additional threedimensional (3D) reconstruction of the glenoid can help simulate the fit of the implant preoperatively. Higher amounts of eccentric wear can be corrected using a full-wedge (15°) metallic augmented baseplate. Preoperative planning is essential in order to understand the ideal implant position and size and also to prevent excessive medialization while reaming.
Operative technique The patient is placed in conventional beach-chair position. After marking all bony landmarks, a standard deltopectoral approach is used, with retraction of the deltoid mu
Data Loading...
