Posterior glenoid bone grafting in total shoulder arthroplasty for osteoarthritis with severe posterior glenoid wear

Gregory P. Nicholson, Gregory L. Cvetanovich, Allison J. Rao, Patrick O'Donnell

Research output: Contribution to journalArticlepeer-review

52 Scopus citations

Abstract

Background Total shoulder arthroplasty (TSA) in cases with posterior wear can be addressed by eccentric reaming of the anterior glenoid or by augmenting the posterior glenoid with bone grafting or augmented glenoid implants. We report the results of TSA with posterior glenoid bone grafting (PGBG) with humeral head autograft in patients with shoulder osteoarthritis and severe posterior glenoid wear. Methods A retrospective review of cases from 2004 to 2014 revealed 34 patients. Preoperative and postoperative radiographs were evaluated for glenoid version and humeral head subluxation as well as component loosening. Patient-reported outcomes were compared preoperatively and postoperatively. Complications and reoperations were also evaluated. Results Of the 34 patients, 28 (82.4%) were available at a minimum of 2 years' follow-up. PGBG corrected glenoid retroversion from −28° ± 4° preoperatively to −4° ± 2° (P <.001). Humeral head subluxation also improved after PGBG with respect to the scapular axis and to the midglenoid face (P <.001). Radiographic analysis revealed all PGBGs had incorporated. Radiographically, 3 patients (10.7%) had a total of 5 broken or displaced screws. In addition, 3 patients (10.7%) had a broken metal marker in the center peg of the glenoid component. No patients required component revision surgery by final follow-up. Only 1 reoperation occurred for capsular release. Patients showed significant improvements in all patient-reported outcomes. Conclusion Patients undergoing primary TSA with humeral head autograft PGBG showed significant improvements in glenoid version, humeral head subluxation, patient-reported outcomes, and range of motion at an average of 4 years' follow-up. There was a low revision rate and a high rate of graft incorporation.

Original languageEnglish (US)
Pages (from-to)1844-1853
Number of pages10
JournalJournal of Shoulder and Elbow Surgery
Volume26
Issue number10
DOIs
StatePublished - Oct 1 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2017 Journal of Shoulder and Elbow Surgery Board of Trustees

Keywords

  • Posterior glenoid bone loss
  • glenoid augmentation
  • glenoid wear
  • humeral head autograft
  • posterior glenoid bone grafting
  • total shoulder arthroplasty

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