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Clinical Orthopaedics and Related Research

, Volume 466, Issue 3, pp 599–607 | Cite as

Glenoid Reconstruction in Revision Shoulder Arthroplasty

  • Bassem Elhassan
  • Mehmet Ozbaydar
  • Lawrence D. Higgins
  • Jon J. P. WarnerEmail author
Symposium: New Approaches to Shoulder Surgery

Abstract

Failed shoulder arthroplasty associated with glenoid bony deficiency is a difficult problem. Revision surgery is complex with unpredictable outcome. We asked whether revision shoulder arthroplasty with glenoid bone grafting could lead to good outcome. We retrospectively reviewed 21 patients who underwent glenoid bone grafting using corticocancellous bone grafting or impaction grafting using cancellous bone graft. Three patients underwent revision TSA, five patients hemiarthroplasty, 10 patients hemiarthroplasty with biologic resurfacing of the glenoid, and three patients revision to reverse TSA. The patients had minimum 25 months followup (average, 45 months; range, 25–92 months). All patients had improvement in their range of motion and the Constant-Murley score. Most improvement occurred in patients with glenoid reimplantation. Patients who underwent revision reverse TSA had improvement in shoulder flexion but decrease in external rotation motion. We conclude revision shoulder arthroplasty with glenoid bone grafting can produce good short-term outcome and glenoid component reinsertion should be attempted whenever possible.

Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Keywords

External Rotation Shoulder Arthroplasty Total Shoulder Arthroplasty Glenoid Component Forward Flexion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Antuna SA, Sperling JW, Cofield RH, Rowland CM. Glenoid revision surgery after total shoulder arthroplasty. J Shoulder Elbow Surg. 2001;10:217–224.PubMedCrossRefGoogle Scholar
  2. 2.
    Barrett WP, Franklin JL, Jackins SE, Wyss CR, Matsen FA 3rd. Total shoulder arthroplasty. J Bone Joint Surg Am. 1987;69:865–872.PubMedGoogle Scholar
  3. 3.
    Barrett WP, Thornhill TS, Thomas WH, Gebhart EM, Sledge CB. Nonconstrained total shoulder arthroplasty in patients with polyarticular rheumatoid arthritis. J Arthroplasty. 1989;4:91–99.PubMedCrossRefGoogle Scholar
  4. 4.
    Bonutti PM, Hawkins RJ. Component loosening in unconstrained shoulder arthroplasty. Semin Arthroplasty. 1990;1:124–128.Google Scholar
  5. 5.
    Boyd AD, Thomas WH, Sledge CB, Thornhill TS. Failed shoulder arthroplasty. Orthop Trans. 1990;14:255–261.Google Scholar
  6. 6.
    Brenner BC, Ferlic DC, Clayton ML, Dennis DA. Survivorship of unconstrained total shoulder arthroplasty. J Bone Joint Surg Am. 1989;71:1289–1296.PubMedGoogle Scholar
  7. 7.
    Carroll RM, Izquierdo R, Vazquez M, Blaine TA, Levine WN, Bigliani LU. Conversion of painful hemiarthroplasty to total shoulder arthroplasty: Long-term results. J Shoulder Elbow Surg. 2004;13:599–603.PubMedCrossRefGoogle Scholar
  8. 8.
    Cofield RH. Revision procedures for shoulder arthroplasty. In: Morrey BF, An KN, eds. Reconstructive Surgery of the Joints. 2nd ed. New York, NY: Churchill Livingstone; 1996:789–799.Google Scholar
  9. 9.
    Cofield RH, Edgerton BC. Total shoulder arthroplasty: complications and revision surgery. Instr Course Lect. 1990;39:449–462.PubMedGoogle Scholar
  10. 10.
    Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;214:160–164.PubMedGoogle Scholar
  11. 11.
    Hawkins RJ, Greis PE, Bonutti PM. Treatment of symptomatic glenoid loosening following unconstrained shoulder arthroplasty. Orthopedics. 1999;22:229–234.PubMedGoogle Scholar
  12. 12.
    Neer CS 2nd, Morrison DS. Glenoid bone-grafting in total shoulder arthroplasty. J Bone Joint Surg Am. 1988;70:1154–1162.PubMedGoogle Scholar
  13. 13.
    Neyton L, Boileau P, Nove-Josserand L, Edwards TB, Walch G. Glenoid bone grafting with a reverse design prosthesis. J Shoulder Elbow Surg. 2007;16:S71–78. Epub 2006 Sep 20.PubMedCrossRefGoogle Scholar
  14. 14.
    Neyton L, Sirveaux F, Roche O, Mole D, Boileau P, Walch G. Results of revision surgery for glenoid loosening: a multicentric series of 37 shoulder prosthesis [in French]. Rev Chir Orthop Reparatrice Appar Mot. 2004;90:111–121.PubMedGoogle Scholar
  15. 15.
    Neyton L, Walch G, Nove-Josserand L, Edwards TB. Glenoid corticocancellous bone grafting after glenoid component removal in the treatment of glenoid loosening. J Shoulder Elbow Surg. 2006;15:173–179.PubMedCrossRefGoogle Scholar
  16. 16.
    Phipatanakul WP, Norris TR. Treatment of glenoid loosening and bone loss due to osteolysis with glenoid bone grafting. J Shoulder Elbow Surg. 2006;15:84–87.PubMedCrossRefGoogle Scholar
  17. 17.
    Seltzer DG, Wirth MA, Rockwood CA, Senes H. Revision shoulder arthroplasty. Orthop Trans. 1996;19:773–777.Google Scholar
  18. 18.
    Sperling JW, Cofield RH. Revision total shoulder arthroplasty for the treatment of glenoid arthrosis. J Bone Joint Surg Am. 1998;80:860–867.PubMedGoogle Scholar
  19. 19.
    Steinmann SP, Cofield RH. Bone grafting for glenoid deficiency in total shoulder replacement. J Shoulder Elbow Surg. 2000;9:361–367.PubMedCrossRefGoogle Scholar
  20. 20.
    Torchia ME, Cofield RH, Settergren CR. Total shoulder arthroplasty with the Neer prosthesis: long-term results. J Shoulder Elbow Surg. 1997;6:495–505.PubMedCrossRefGoogle Scholar

Copyright information

© The Association of Bone and Joint Surgeons 2008

Authors and Affiliations

  • Bassem Elhassan
    • 1
  • Mehmet Ozbaydar
    • 1
  • Lawrence D. Higgins
    • 2
  • Jon J. P. Warner
    • 3
    Email author
  1. 1.Harvard Shoulder Service, Harvard Medical SchoolMassachusetts General HospitalBostonUSA
  2. 2.Sports Medicine and the Shoulder ServiceHarvard Medical School, Brigham and Women’s HospitalBostonUSA
  3. 3.Division of Shoulder Surgery, Department of Orthopedic Surgery, Harvard Shoulder Service, Harvard Medical SchoolMassachusetts General HospitalBostonUSA

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