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Augmented Glenoid Replacement for Total Shoulder Arthroplasty

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Abstract

Degenerative arthritis resulting in asymmetric posterior glenoid wear presents management challenges for the treating surgeon. Factors that must be considered include the structural management of the bone deficiency, addressing posterior humeral head subluxation, and understanding the survivability of the various treatment techniques. Unfortunately, the literature to date is incomplete as it pertains to the long-term success rate of the various arthroplasty options for management of moderate to severe glenoid bone loss.

There are several options for management of glenoid bone loss and associated retroversion, which include hemiarthroplasty, glenoid realignment with bony reaming, bone grafting, reverse shoulder arthroplasty, and augmented implants. Unfortunately, no one management technique has demonstrated clinical superiority. Recently, there has been renewed interest in posteriorly augmented glenoid implants. Several orthopedic implant manufacturers have developed posteriorly augmented glenoid implants with various backside geometries to minimize anterior glenoid bone removal and maximize implant stability and survivability. These implants attempt to restore glenoid retroversion and re-center the humeral head during anatomic total shoulder arthroplasty by reconstructing the glenoid bony erosion with polyethylene. Unfortunately, there are no medium- or long-term outcomes on the use of these contemporary augmented implants to manage posterior bone loss. However, it appears that in the short term, the outcomes of augmented glenoid components are encouraging.

Keywords

Glenohumeral arthritis Biconcave glenoid Posterior subluxation B2 glenoid B3 glenoid Glenoid erosion Implant fixation Posterior erosion Augmented implants 

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Roth|McFarlane Hand and Upper Limb CentreSt. Joseph’s Health CareLondonCanada
  2. 2.Department of Mechanical and Materials EngineeringUniversity of Western OntarioLondonCanada

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