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Glenoid Reconstruction in Revision Shoulder Arthroplasty

  • Symposium: New Approaches to Shoulder Surgery
  • Published:
Clinical Orthopaedics and Related Research

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.

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Authors and Affiliations

  1. Harvard Shoulder Service, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA

    Bassem Elhassan MD & Mehmet Ozbaydar MD

  2. Sports Medicine and the Shoulder Service, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA

    Lawrence D. Higgins MD

  3. Division of Shoulder Surgery, Department of Orthopedic Surgery, Harvard Shoulder Service, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA

    Jon J. P. Warner MD

Authors
  1. Bassem Elhassan MD
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  2. Mehmet Ozbaydar MD
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  3. Lawrence D. Higgins MD
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  4. Jon J. P. Warner MD
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Corresponding author

Correspondence to Jon J. P. Warner MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the human protocol for this investigation, and that all investigations were conducted in conformity with ethical principles of research.

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Elhassan, B., Ozbaydar, M., Higgins, L.D. et al. Glenoid Reconstruction in Revision Shoulder Arthroplasty. Clin Orthop Relat Res 466, 599–607 (2008). https://doi.org/10.1007/s11999-007-0108-0

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  • DOI: https://doi.org/10.1007/s11999-007-0108-0

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