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Replacement options for the B2 glenoid in osteoarthritis of the shoulder: a biomechanical study

  • Orthopaedic Surgery
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Abstract

Background

Glenoid replacement in cases of severe glenoid retroversion (RV) or eccentric wear is challenging. The aim of this study was to evaluate different treatment methods under standardized conditions to assist surgeons in the decision-making process.

Methods

Three treatment options for severe glenoid RV (15°) were compared: (1) no RV correction; (2) complete RV correction; (3) no RV correction and implantation of a posterior augmented glenoid (PAG). A highly standardized implantation protocol using artificial glenoid bones (five per group) was chosen, and a physiologic shoulder movement was applied in a biomechanical setting. Micromotions (MM) between glenoid components and bone were quantified using an optical 3D measuring system.

Results

In the uncorrected retroversion group, three instances of subluxation of the prosthetic head occurred between 2000 and 4000 cycles. At 2000 cycles, significantly more MM were observed in the uncorrected RV group than in the corrected RV group (p < 0.0001) or to the augmented group (p < 0.0001). At 10|000 cycles, more MM were observed in the posterior augmented group than in the corrected RV group (p < 0.0001).

Conclusion

If sufficient bone stock is available, retroversion correction should be favored. Posterior augmented glenoids seem to be a suitable treatment option if complete correction of the retroversion is not possible without compromising the glenoid vault. Without correction of the retroversion, high failure rates were observed.

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Acknowledgements

We would like to thank the non-profit research fund of Stiftung Endoprothetik (Hamburg, Germany) for supporting this study.

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Authors and Affiliations

  1. Clinic of Orthopedic and Trauma Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany

    Boris Sowa, Martin Bochenek, Steffen Braun, Felix Zeifang, Jan Philippe Kretzer & Patric Raiss

  2. Institute of Medical Biometry and Informatics, Universität Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany

    Thomas Bruckner

  3. Hôpital Privé Jean-Mermoz-GDS Ramsay, 24, Avenue Paul Santy, 69008, Lyon, France

    Gilles Walch

  4. OCM (Orthopädische Chirurgie München) Clinic, Steinerstrasse 6, 81369, Munich, Germany

    Patric Raiss

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  1. Boris Sowa
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Correspondence to Patric Raiss.

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Conflict of interest

Gilles Walch receives royalties from Wright Medical. Gilles Walch, Felix Zeifang and Patric Raiss have consultancy contracts with Wright Medical. The other authors, their immediate families, and any research foundations with which they are affiliated have received no financial payments or other benefits from any commercial entity related to the subject of this article. The prostheses used for this investigation were supplied free of charge by the manufacturer (Wright Medical®, Memphis, Tennessee, USA). The manufacturer had no influence on the design or results of this study.

Ethical statement

The study is original and not under review by another journal. Ethical approval is not required, as for this biomechanical investigation only artificial bones were used.

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Sowa, B., Bochenek, M., Braun, S. et al. Replacement options for the B2 glenoid in osteoarthritis of the shoulder: a biomechanical study. Arch Orthop Trauma Surg 138, 891–899 (2018). https://doi.org/10.1007/s00402-018-2915-z

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  • DOI: https://doi.org/10.1007/s00402-018-2915-z

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