Introduction: We describe a bone-graft technique, for shoulder arthroplasty in patients with severe glenoid bone loss, that utilizes a "step cut," a trapezoidal bone wedge from the resected humeral head, and graft fixation with screws placed from posterior to anterior through the graft.
Step 1 Preoperative Planning: Carry out preoperative planning for the step-cut procedure.
Step 2 Surgical Approach And Preparation Of The Glenoid: Expose the glenoid for bone graft insertion, taking care to avoid excessive reaming.
Step 3 Prepare The Glenoid Bone Graft: Cut the appropriately sized glenoid bone graft from the resected humeral head.
Step 4 Insert And Fix The Glenoid Bone Graft: Position the bone graft in the glenoid defect and stabilize it with screws.
Step 5 Prepare The Glenoid Surface: Create an even concave surface between the anterior aspect of the glenoid and the posterior aspect of the graft.
Step 6 Place The Glenoid Implant: Position the glenoid component following step-cut graft implantation.
Postoperative Rehabilitation: Postoperative rehabilitation is mostly the same as that for standard total shoulder replacement without bone-grafting.
Results: The range of motion improved significantly in our study of twelve patients (p < 0.001).IndicationsContraindicationsPitfalls & Challenges.
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| http://dx.doi.org/10.2106/JBJS.ST.M.00052 | DOI Listing |
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