Shoulder Arthroplasty in the Presence of Posterior Glenoid Bone Loss

by Scott P. Stephens, Kevin C. Paisley, Jeffrey Jeng, Anil K. Dutta, and Michael A. Wirth

J Bone Joint Surg AmVolume 97(3):251-259

February 4, 2015

©2015 by The Journal of Bone and Joint Surgery, Inc.

Type-A glenoids have a well-centered humeral head and either minor (A1) or major (A2) central erosion.

Scott P. Stephens et al. J Bone Joint Surg Am 2015;97:251-259

©2015 by The Journal of Bone and Joint Surgery, Inc.

The effective glenoid arc is the arc of the glenoid that is able to support the net humeral joint reaction force.

Scott P. Stephens et al. J Bone Joint Surg Am 2015;97:251-259

©2015 by The Journal of Bone and Joint Surgery, Inc.

Preoperative axillary radiograph.

Scott P. Stephens et al. J Bone Joint Surg Am 2015;97:251-259

©2015 by The Journal of Bone and Joint Surgery, Inc.

Preoperative axial CT scan of the biconcave glenoid with approximately 5.5 mm of posterior glenoid bone loss and associated humeral head subluxation as measured with the technique

described by Sabesan et al.70.

Scott P. Stephens et al. J Bone Joint Surg Am 2015;97:251-259

©2015 by The Journal of Bone and Joint Surgery, Inc.

Postoperative axillary radiograph demonstrating improvement of version to 2° of retroversion and improved subluxation with placement of an augmented glenoid component (Global

Steptech; DePuy, Warsaw, Indiana).

Scott P. Stephens et al. J Bone Joint Surg Am 2015;97:251-259

©2015 by The Journal of Bone and Joint Surgery, Inc.

The stepped glenoid component with 3 mm of glenoid augmentation (Global Steptech).

Scott P. Stephens et al. J Bone Joint Surg Am 2015;97:251-259

©2015 by The Journal of Bone and Joint Surgery, Inc.

The prepared glenoid with a posterior step-cut (small arrowheads) and prepared central and peripheral peg holes is shown, with the axillary nerve indicated by the large arrow.

Scott P. Stephens et al. J Bone Joint Surg Am 2015;97:251-259

©2015 by The Journal of Bone and Joint Surgery, Inc.