step-cut bone-graft technique for osteoarthritis with severe glenoid bone loss by vani sabesan,...
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Step-Cut Bone-Graft Technique for Osteoarthritis with Severe Glenoid Bone Loss
by Vani Sabesan, Vinay Sharma, Mark Callanan, Jason Ho, and Joseph Iannotti
JBJS Essent Surg TechVolume 4(3):e14
July 22, 2014
©2014 by The Journal of Bone and Joint Surgery, Inc.
The glenoid plane is defined by three points (Fig. 1-A), and glenoid bone loss is measured as the difference from the normal anatomy based on the vault model and the pathological anatomy
based on midlevel axial cuts (Fig. 1-B).
Vani Sabesan et al. JBJS Essent Surg Tech 2014;4:e14
©2014 by The Journal of Bone and Joint Surgery, Inc.
The posterior side of the glenoid is burred as a step cut to a depth similar to the defect.
Vani Sabesan et al. JBJS Essent Surg Tech 2014;4:e14
©2014 by The Journal of Bone and Joint Surgery, Inc.
The superior-inferior and anterior-posterior dimensions of the prepared posterior defect are measured, and a template is cut to match the shape and size of the posterior defect.
Vani Sabesan et al. JBJS Essent Surg Tech 2014;4:e14
©2014 by The Journal of Bone and Joint Surgery, Inc.
Access to the joint is achieved by placing a lamina spreader into the joint in contact with the anterior aspect of the glenoid and the humeral osteotomy surface.
Vani Sabesan et al. JBJS Essent Surg Tech 2014;4:e14
©2014 by The Journal of Bone and Joint Surgery, Inc.
The bone graft is stabilized with 2.0-mm Kirschner wires (Fig. 5-A) as well as 4.0-mm cannulated cancellous screws (Fig. 5-B).
Vani Sabesan et al. JBJS Essent Surg Tech 2014;4:e14
©2014 by The Journal of Bone and Joint Surgery, Inc.
The graft and native glenoid are reamed to yield a uniform surface (Fig. 6-A).
Vani Sabesan et al. JBJS Essent Surg Tech 2014;4:e14
©2014 by The Journal of Bone and Joint Surgery, Inc.