Authors’ Disclosure Statement: Dr. Wright reports that he receives royalties and has a consultancy agreement with Exactech. The University of Florida Department of Orthopaedics and Rehabilitation receives research support from Exactech. The other authors report no actual or potential conflict of interest in relation to this article.
Dr. Michael is a Fellow, Department of Orthopaedics and Rehabilitation; Dr. Schoch is an Assistant Professor; Dr. King is an Associate Professor; and Dr. Wright is a Professor, Orthopaedics and Sports Medicine Institute, University of Florida, Gainesville, Florida.
Address correspondence to: Thomas W. Wright, MD, Orthopaedics and Sports Medicine Institute, University of Florida, 3450 Hull Road, Gainesville, FL, 32611, USA. (tel, 352-273-7375; fax: 352-273-7293; email, wrightw@ortho.ufl.edu).
Am J. Orthop. 2018;47(2). Copyright Frontline Medical Communications Inc. 2018. All rights reserved.
Rowan J. Michael, MD Bradley S. Schoch, MD Joseph J. King, MD Thomas W. Wright, MD . Managing Glenoid Bone Deficiency—The Augment Experience in Anatomic and Reverse Shoulder Arthroplasty. Am J Orthop. March 5, 2018
TAKE-HOME POINTS
Glenoid defects are very common.
Options for treating glenoid defects include eccentric reaming, bone grafting, and augmented glenoids.
As computer-assisted surgery use becomes more widespread the use of augments in both TSA and RTSA will become very common.
Subchondral bone is precious and cannot be replaced once reamed away. Eccentric glenoids introduce a mechanism to minimize reaming and preserve this precious bone.
On short-term to midterm follow-up augments perform at least as well if not better than non-augmented glenoid components with complication rate and revisions likewise similar.
References
ABSTRACT
Glenoid bone deficiency in the setting of shoulder replacement surgery is far more common than originally reported. The frequency and severity of the glenoid defects are noted to be more common and severe with the advent of computer-assisted surgery. The results of an anatomic total shoulder arthroplasty (aTSA) with glenoid deficiency have been reported to be inferior to aTSA patients without a glenoid deficiency. Options for treating the glenoid deficiency include eccentric reaming, bone grafting, and the use of augmented glenoid components. The purpose of this article is to present the indications, technique, and results of augmented glenoids for both aTSA and reverse TSA (RTSA).
Augments for both aTSA and RTSA are viable options. They preserve subchondral bone at the same time as optimizing the joint line without the need for bone grafts. Complications, revisions and results are as good as compared to shoulder arthroplasties without glenoid wear.
