Glenoid revision surgery after total shoulder arthroplasty

Bone Grafting Severe Glenoid Defects in Revision Shoulder Arthroplasty

“…In situations of severe glenoid bone defects in failed TSA, bone grafting the defect without prosthetic glenoid reimplantation may be the only viable surgical option, a solution that has received only sparse attention in the literature [1,17,18]. The purpose of the current study was to report on the fate of the bone graft and the associated clinical outcomes of patients undergoing revision shoulder arthroplasty with extensive glenoid bone grafting for severe defects.…”

“…Improved clinical outcomes have been reported when the glenoid could be revised with a new resurfacing implant [1,2,17,18]. For this reason, it is our practice to revise the glenoid with a new prosthesis when possible.…”

“…Based on glenoid defects in 48 patients at the time of revision arthroplasty, Antuna et al [1] classified defects into central, peripheral, and combined with further subdivision into mild, moderate, and severe. They emphasized the difficulties in treating defects involving the glenoid vault and walls.…”

“…One patient underwent preoperative shoulder aspiration. At the time of surgery, glenoid bone deficiency was evaluated according to the classification described by Antuna et al [1]; defects are classified as central, peripheral, and combined with further subdivision into mild, moderate, and severe.…”

“…When combined with defects of the thin cortical vault walls, implantation of a new glenoid component may not be possible. Bone grafting the glenoid defect without new glenoid component implantation combined with hemiarthroplasty is a reconstructive option in these circumstances [1,17,18]. However, previous reports have not described the extent of graft subsidence [1], the use of structural allograft for reconstruction of cavitary defects combined with glenoid vault wall defects [17], or the clinical outcomes after glenoid bone grafting [18].…”