Reverse Shoulder Arthroplasty by Dines David M.;Dines Joshua;Edwards T. Bradley;

Author:Dines, David M.;Dines, Joshua;Edwards, T. Bradley;
Language: eng
Format: epub
Publisher: Thieme Medical Publishers, Incorporated
Published: 2017-09-02T00:00:00+00:00

Results

The high failure rate of posterior bone grafting and the inability to durably correct posterior instability of the humeral head with an anatomic TSA led Mizuno et al to investigate the use of a primary RSA for a B2 glenoid.28 A retrospective review was performed of 27 RSAs implanted for primary glenohumeral arthritis with a B2 glenoid that were reviewed at a mean of 54 months postoperative. Ten patients underwent glenoid bone grafting to address posterior glenoid erosion: three cases were performed as a two-stage procedure with iliac crest bone graft, one case was performed as a single-stage procedure with iliac crest bone graft, and the final six cases were performed with our current technique of choice as a single-stage procedure with humeral head autograft following the BIO-RSA (Tornier Inc., Edina, MN) technique described by Boileau et al (► Fig. 14.7).29 The mean Constant score increased from 31 to 76 and no recurrence of posterior instability was observed. One patient, in whom glenoid bone grafting was performed with a 15-mm central post (as opposed to the 25-mm central post currently used), experienced early glenoid loosening. These results demonstrate that an RSA can provide a solution to the static posterior instability and posterior glenoid erosion that occurs with a B2 glenoid.

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