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Outcomes after shoulder arthroplasty revision with glenoid reconstruction and bone grafting

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Abstract

Purpose

Extensive glenoid bone loss after failed shoulder arthroplasty represents a challenge for revision arthroplasty. Treatment options vary widely and have been a source of controversy among experts.

Methods

Between 2004 and 2010, a total of 17 patients underwent glenoid reconstruction surgery using an autologous iliac crest bone graft and secondary revision arthroplasty due to extensive glenoid bone loss after failed previous total shoulder arthroplasty. The outcomes were assessed by means of clinical examination, Constant score, and bi-plane radiography as well as pre-, postoperative and follow-up CT.

Results

Before the revision surgery, the mean Constant score was 24 ± 17 and improved to 40 ± 13 after the glenoid rebuilding and revision arthroplasty. CT imaging revealed adequate glenoid bone stock restoration with no relevant graft resorption or loosening of the glenoid. The average postoperative antero-posterior diameter of the glenoid was 28 ± 3 mm which had decreased to 25 ± 3 mm at follow-up. The average postoperative version of the glenoid was 95.7° ± 6° and had decreased to 98.5° ± 4° at follow-up. Both the glenoid version and diameter had changed significantly (P < 0.001) comparing postoperative and follow-up CT-scans.

Conclusion

Glenoid reconstruction surgery using an iliac crest bone-block autograft prior to revision arthroplasty represents a valuable salvage procedure in cases of extensive glenoid bone loss after primary shoulder arthroplasty. Sufficient glenoid bone stock restoration is indispensable for reliable fixation of glenoid components and in turn a satisfactory clinical outcome.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

415-EP/73/171-2012

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Authors and Affiliations

  1. Department of Traumatology and Sports Injuries, Paracelsus Medical University Salzburg, Muellner Hauptstrasse 48, 5020, Salzburg, Austria

    Thomas Hoffelner, Philipp Moroder, Alexander Auffarth & Herbert Resch

  2. Shoulder and Elbow Surgery, ATOS Clinic Munich, Munich, Germany

    Mark Tauber

Authors
  1. Thomas Hoffelner
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  2. Philipp Moroder
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  3. Alexander Auffarth
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  4. Mark Tauber
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  5. Herbert Resch
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Corresponding author

Correspondence to Thomas Hoffelner.

Additional information

Work was performed at the Paracelsus Medical University Salzburg, Austria.

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Hoffelner, T., Moroder, P., Auffarth, A. et al. Outcomes after shoulder arthroplasty revision with glenoid reconstruction and bone grafting. International Orthopaedics (SICOT) 38, 775–782 (2014). https://doi.org/10.1007/s00264-013-2191-z

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  • DOI: https://doi.org/10.1007/s00264-013-2191-z

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