Bulletin of the Hospital for Joint Disease (2013)
-
Bull Hosp Jt Dis (2013) · Dec 2015
Comparative StudyThe Impact of Posterior Wear on Reverse Shoulder Glenoid Fixation.
Achieving glenoid fixation with posterior bone loss can be challenging. The purpose of this study was to quantify the impact of two different sizes of posterior glenoid defects (10° and 20°) on reverse shoulder arthroplasty (rTSA) glenoid baseplate fixation and determine if utilizing different sizes of posterior augmented baseplates (8° and 16°) with off-axis reaming provides comparable fixation to using a standard baseplate with different amounts of eccentric reaming. ⋯ Both standard baseplates with eccentric reaming and two different sizes of augmented baseplates with off-axis reaming successfully maintained fixation following cyclic loading in composite scapula with corrected 10° and 20° posterior glenoid defects. Augmented glenoids may be more advantageous long-term from a fixation perspective as they preserve more subchondral glenoid bone due to the minimal reaming occurring by the off-axis method. Mid and long-term clinical follow-up comparisons of outcomes are necessary between these two techniques.
-
Bull Hosp Jt Dis (2013) · Dec 2015
Impact of Posterior Wear on Muscle Length with Reverse Shoulder Arthroplasty.
The use of reverse total shoulder arthroplasty (rTSA) in patients with posterior glenoid wear can be challenging. Implanting a baseplate in the correct version may require significant eccentric reaming, which further medializes the joint line and results in greater rotator cuff muscle shortening. To restore the joint line, bone graft may be required, though it is associated with additional risks. ⋯ More anatomic rotator cuff muscle tensioning was observed with augmented glenoid baseplates. The use of posterior augmented glenoid baseplates has the potential to improve stability and better restore active internal and external rotation, a current limitation of rTSA. However, clinical follow-up is necessary to confirm these favorable biomechanical results.