Comparison of Asymmetric Reaming versus a Posteriorly Augmented Component for Posterior Glenoid Wear and Retroversion: A Radiographic Study | ||
| The Archives of Bone and Joint Surgery | ||
| مقاله 2، دوره 7، شماره 4، مهر 2019، صفحه 307-313 اصل مقاله (949.58 K) | ||
| نوع مقاله: RESEARCH PAPER | ||
| شناسه دیجیتال (DOI): 10.22038/abjs.2019.28430.1751 | ||
| نویسندگان | ||
| Jia-Wei Kevin Ko1؛ Usman Ali Syed2؛ Jonathan D. Barlow3؛ Scott Paxton4؛ Bryan J. Loeffler5؛ Ocean Thakar2؛ Grant Jamgochian2؛ Joseph Abboud* 2؛ Charles L. Getz2؛ Gerald R. Williams2 | ||
| 1Orthopedic Physician Associates at Swedish Orthopedic Insitiute, Seattle, WA, USA | ||
| 2The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA | ||
| 3Ohio State University, Wexner Medical Center, Columbus, OH, USA | ||
| 4Brown University, Providence, RI, USA | ||
| 5OrthoCarolina, Charlotte, NC, USA | ||
| چکیده | ||
| Background: Managing posterior glenoid wear and retroversion remains a challenge in shoulder arthroplasty. Correcting glenoid version through asymmetric reaming (AR) with placement of a standard glenoid component and the use of posteriorly augmented glenoid (PAG) components are two methods used to address this problem. Our objective is to report the radiographic outcomes of patients with posterior glenoid wear and/or retroversion treated with either approach. Methods: Patients with posterior glenoid wear and a minimum of 15 degrees of retroversion, treated with AR and standard glenoid component or with a PAG component (3 mm, 5 mm, or 7 mm posterior augmentation), were consecutively identified through retrospective chart review. Pre-operative axillary views were evaluated for version, humeral head subluxation in relation to scapular axis and to mid-glenoid face. Post-operative axillary views were reviewed to measure corrected inversion and humeral head subluxation. Results: There were 48 patients in the AR group and 49 patients in the PAG group. Version improved 6.8 degrees in the AR group. In the PAG group, version improved 8.8 degrees with 3 mm augment, 13.4 degrees with 5 mm augment, and 12.8 with 7 mm augments. There were significantly more central peg perforations in the 5 mm PAG group compared to other groups. The humeral head was re-centered within 6.1% of normal in all groups except 7 mm augments. Conclusion: This study demonstrates that AR and PAGs have the ability to re-center the humeral head when utilized in patients with retroversion and posterior wear. Use of a PAG component may allow for greater correction of glenoid retroversion, however, there is an increased risk for central peg perforation with the specific implant utilized in this study. Long-term follow-up is ongoing and needed to understand the clinical implications of these findings. Level of evidence: IV | ||
| کلیدواژهها | ||
| Augmented glenoid؛ Glenoid reaming؛ Shoulder arthritis؛ Total shoulder arthoplasty | ||
| مراجع | ||
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