The Use of an External Cutting Guide for Patient-Specific Bone Grafting in Reverse Total Shoulder Arthroplasty: A Novel Technique.

Glenoid bone loss remains a substantial challenge in reverse shoulder arthroplasty and failure to address such bone loss may lead to implant malpositioning, instability and/or premature baseplate loosening. Currently, management of glenoid bone loss can be achieved by metal augmentation or bone grafting (ie, autograft or allograft). At the present time, options for creating and shaping glenoid bone grafts include free-hand techniques and simple reusable cutting guides that create the graft at a standard shape/angle. To our knowledge, there is no external guide available that enables surgeons to accurately prepare the bone graft to the desired dimensions/shape (ie, trapezoid or biplanar) to correct the glenoid deformity. In this article, we present a novel surgical technique that utilizes an external guide for creating a patient-specific bone graft to address glenoid deformity in the setting of reverse total shoulder arthroplasty.