Background: Management of glenoid bone defects during reverse shoulder arthroplasty remains a challenge. The aim of our study was to preoperatively localize the maximal depth of glenoid bone defects in relation to glenoid reaming.
Methods: Thirty preoperative shoulder computed tomography scans were collected. Three assessors created standardized surgical plans, using 3-dimensional (3D) computed tomography-based Blueprint planning software in which the reaming axis was held constant at zero degrees of version and inclination. Each plan resulted in a 2-dimensional (2D) image of the reamer's contact on the glenoid and a corresponding 3D representation of the glenoid bone defect. The position of the maximum glenoid defect was localized on both the 2D and 3D images. Descriptive statistics were calculated. The correlation between angles from 2D and 3D images was assessed, and intraclass correlation was used to assess inter-rater and intrarater reliability.
Results: Twenty-eight patients were included. The overall mean difference between 2D and 3D angles was 5.4° (standard deviation 5.2°). The correlation between 2D and 3D angles was almost perfect. Intraclass correlation results demonstrated near-perfect agreement. The maximal glenoid defect was within 5% of a circle (or +/- 9°) from perpendicular to the high-side ream line in 85.1% of comparisons and was within 10% of a circle in 97.6% of comparisons.
Conclusion: Using Blueprint planning software, we have demonstrated with almost perfect agreement among 3 assessors that when the reaming axis is held constant, the maximum glenoid bone defect is reliably located perpendicular to the glenoid ream line.
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| http://dx.doi.org/10.1016/j.jseint.2021.04.001 | DOI Listing |
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Article Synopsis
- The optimal treatment for B2 glenoid morphology in young, active osteoarthritis patients is debated, with various options like hemiarthroplasty, total shoulder arthroplasty (TSA), and reverse TSA available, each having pros and cons.
- Eccentric glenoid reaming can be effective but risks damaging the bone structure, potentially complicating future surgeries, while bone grafting, though beneficial for some, comes with high complication rates.
- Reverse TSA offers a more stable alternative when correcting version and inclination proves difficult, as it adapts better to glenoid deformities and maintains functionality with reduced bone stock.
Radiological Outcome in Reverse Shoulder Arthroplasty does not correlate with patient satisfaction or quality of life.
J Shoulder Elbow Surg
December 2024
Department of Trauma Surgery and Orthopedics - Medical University of Vienna, AKH Wien, Vienna, Austria. Electronic address:
Background: While outcomes following reverse shoulder arthroplasty (rTSA) have often been gauged through radiological assessments focusing on prosthesis position, there is increasing recognition of patient-reported outcomes, particularly satisfaction, as indicators of surgical success. The objective of this study was to correlate radiological findings with clinical outcomes, patient satisfaction, and health-related quality of life (HRQoL).
Materials And Methods: A retrospective evaluation was conducted on patients following rTSA at a minimum of two years postoperatively.
A Novel Proportional Method for the Simplified Assessment of Glenoid Bone Loss in Patients With Anterior Shoulder Instability.
Am J Sports Med
January 2025
Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun, China.
Article Synopsis
- Surgical planning for anterior shoulder instability (ASI) requires accurate glenoid bone defect measurements, but existing methods are often complicated or impractical.
- The study developed a new measurement technique using CT scans that simplifies the assessment of anterior glenoid bone defects while maintaining accuracy.
- Results indicated that the new proportional method produced similar measurements to other established methods, with a convenient calculation of glenoid width based on height, while the CT-specific formula showed significant deviations in defect size and ratio.
Mid- to Long-Term Clinical Outcomes and Failure Rates After ALPSA Lesion Repair.
Am J Sports Med
January 2025
Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Background: Anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesions are associated with recurrent shoulder instability and higher rates of failure after capsulolabral repair compared with similarly treated Bankart lesions. Although these lesions can portend poor outcomes, there are limited data on the associated conditions and postoperative course in a young, active population.
Purpose: To evaluate the mid- to long-term clinical course and failure rates after ALPSA repairs and assess features associated with these outcomes.
Implant survival at four years for hemiarthroplasty and total shoulder arthroplasty in the treatment of atraumatic avascular necrosis of the humeral head.
Bone Joint J
January 2025
Department of Orthopaedics, Medical Spectrum Twente, Enschede, Netherlands.
Aims: Hemiarthroplasty (HA) and total shoulder arthroplasty (TSA) are often the preferred forms of treatment for patients with atraumatic avascular necrosis of the humeral head when conservative treatment fails. Little has been reported about the survival of HA and TSA for this indication. The aim of this study was to investigate the differences in revision rates between HA and TSA in these patients, to determine whether one of these implants has a superior survival and may be a better choice in the treatment of this condition.
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