Reverse Total Shoulder Arthroplasty for Primary Glenohumeral Osteoarthritis in Patients with a Biconcave Glenoid

Mizuno, Naoko; Denard, Patrick J.; Raiss, Patric; Walch, Gilles

doi:10.2106/jbjs.l.00820

Cited by 356 publications

(196 citation statements)

References 2 publications

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“…It is associated with an increased rate of failure with conventional total shoulder arthroplasty [25,49], causing surgeons to consider more complex and potentially more risk-prone options, such as posterior glenoid bone grafting to add support to the prosthetic glenoid component [39] or reverse total shoulder arthroplasty [29]. The ream and run is a glenohumeral arthroplasty that combines humeral hemiarthroplasty with conservative glenoid reaming just sufficient to convert the biconcavity to a single concavity, but without attempting to normalize glenoid version and without insertion of a prosthetic glenoid component.…”

Section: Discussionmentioning

confidence: 99%

“…This finding is important because some surgeons believe that normalizing glenoid version is necessary to achieve posterior stability, leading them to consider bone grafting under the posterior aspect of the glenoid component [39]. Other surgeons are using the reverse total shoulder arthroplasty as a method for stabilizing the glenohumeral joint in shoulders with the arthritic triad [29]. It is apparent that each of these methods may be useful for treatment of various glenohumeral disorders in different shoulders.…”

Section: Discussionmentioning

confidence: 99%

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Can the Ream and Run Procedure Improve Glenohumeral Relationships and Function for Shoulders With the Arthritic Triad?

Matsen

Warme

Jackins

2015

Clinical Orthopaedics &Amp; Related Research

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Background The arthritic triad of glenoid biconcavity, glenoid retroversion, and posterior displacement of the humeral head on the glenoid is associated with an increased risk of failure of total shoulder joint replacement. Although a number of glenohumeral arthroplasty techniques are being used to manage this complex pathology, problems with glenoid component failure remain. In that the ream and run procedure manages arthritic pathoanatomy without a glenoid component, we sought evidence that this procedure can be effective in improving the centering of the humeral head contact on the glenoid and in improving the comfort and function of shoulders with the arthritic triad without the risk of glenoid component failure.Questions/purposes We asked, for shoulders with the arthritic triad, whether the ream and run procedure could improve glenohumeral relationships as measured on standardized axillary radiographs and patient-reported shoulder comfort and function as recorded by the Simple Shoulder Test. Methods Between January 1, 2006 and December 14, 2011, we performed 531 primary anatomic glenohumeral arthroplasties for arthritis, of which 221 (42%) were ream and run procedures. Of these, 30 shoulders in 30 patients had the ream and run procedure for the arthritic triad and had two years of clinical and radiographic follow-up. These 30 shoulders formed the basis for this case series. The average age of the patients was 56 ± 8 years; all but one were male. Two of the 30 patients requested revision to total shoulder arthroplasty within the first year after their ream and run procedure because of their dissatisfaction with their rehabilitation progress. For the 28 shoulders not having had a revision, we determined on the standardized axillary views before and after surgery the glenoid type, glenoid version (90°minus the angle between the plane of the glenoid face and the plane of the body of the scapula), and location of the humeral contact point with respect to the anteroposterio dimension of the glenoid (the ratio of the distance from the anterior glenoid lip to the contact point divided by the distance between the anterior and posterior glenoid lips). We also recorded the patient's self-assessed shoulder comfort and function before and after surgery using the 12 questions of the Simple Shoulder Test. Results For the 28 unrevised shoulders the mean followup was 3.0 years (range, 2-9.2 years). In these patients, the ream and run procedure resulted in improved centering of the humeral head on the face of the glenoid (preoperative: 75% ± 7% posterior; postoperative: 59% ± 10% posterior; mean difference 16% [95% CI, 13%-19%]; p \ 0.001), notably this improved centering was achieved

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Can the Ream and Run Procedure Improve Glenohumeral Relationships and Function for Shoulders With the Arthritic Triad?

Matsen

Warme

Jackins

2015

Clinical Orthopaedics &Amp; Related Research

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“…Plain radiographs showed severe medialization of the humeral head and a laterally down-sloped acromion (Fig 6). Computed tomography scan showed posterior humeral head subluxation of 98%, 9 poor glenoid bone stock, and grade IV fatty infiltration of the rotator cuff and deltoid (Fig 7).…”

Section: Figmentioning

confidence: 99%

Arthroscopic Glenohumeral Arthrodesis With O-Arm Navigation

Lädermann

Denard

2014

Arthroscopy Techniques

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Glenohumeral arthrodesis is an end-stage salvage operation that has traditionally been performed in an open fashion. In recent years an arthroscopic approach has been described. The purpose of this report was to present an arthroscopic glenohumeral arthrodesis technique with the assistance of O-armebased navigation. An illustrative case example is presented. This technique allows not only a minimally invasive glenohumeral arthrodesis but also precise screw fixation by navigation, which may be particularly useful in cases of limited bone stock and/or bony deformity. Glenohumeral arthrodesis is an end-stage surgical option indicated in cases of permanent brachial plexus injury, post-tumor resection, unreconstructable glenohumeral arthritis, chronic infection, and refractory instability with rotator cuff and deltoid dysfunction. Traditionally, the procedure has been performed in an open manner with screw and/or plate fixation.

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“…Bone grafting in the setting of anatomic total shoulder arthroplasty can be considered for high degrees of retroversion (>25°or 30°) in young patients (<60 years old), although clinical data suggests a higher early complication rate with this technique [15][16][17]. Reverse total shoulder arthroplasty with or without grafting for the highly retroverted glenoid and an intact rotator cuff is a more predictable operation with a lower complication rate although should only be considered in an older patient population (>60 years) [18]. Augmented glenoid components offer a solution for the highly retroverted glenoid that might otherwise be treated with an anatomic arthroplasty and bone grafting.…”

Section: Introductionmentioning

confidence: 99%

Planning software and patient-specific instruments in shoulder arthroplasty

Wylie

Tashjian

2016

Curr Rev Musculoskelet Med

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Computer planning software and patient-specific instrumentation have been investigated in multiple subspecialties of orthopedics with mixed results. Shoulder arthroplasty has evolved over the last decade with improvements in implant design and surgical instrumentation. Despite these advances, glenoid positioning in shoulder arthroplasty continues to be a difficult problem. Recent advances in threedimensional imaging techniques and the use of computer planning software may potentially address some of the common difficulties encountered by surgeons. The addition of patient-specific instrumentation and guides provide an option for patients with significant glenoid deformity that may allow improved accuracy of glenoid component implantation compared to using standard instrumentation. Studies have reported improved positioning of the glenoid component in both anatomic and reverse total shoulder arthroplasty with patientspecific instrumentation and guides. More research is needed to determine whether these improvements lead to better patient-reported outcomes or implant survival. In addition, further studies will be needed to address whether this technology is cost effective for large-scale implementation in the orthopedic community.

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Reverse Total Shoulder Arthroplasty for Primary Glenohumeral Osteoarthritis in Patients with a Biconcave Glenoid

Cited by 356 publications

References 2 publications

Can the Ream and Run Procedure Improve Glenohumeral Relationships and Function for Shoulders With the Arthritic Triad?

Can the Ream and Run Procedure Improve Glenohumeral Relationships and Function for Shoulders With the Arthritic Triad?

Arthroscopic Glenohumeral Arthrodesis With O-Arm Navigation

Planning software and patient-specific instruments in shoulder arthroplasty

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