Posters
Academic Level (Author 1)
Medical Student
Academic Level (Author 3)
Faculty
Discipline/Specialty (Author 3)
Orthopedic Surgery
Discipline Track
Patient Care
Abstract
Introduction: Reverse shoulder arthroplasty (RSA) has expanded its indications and use in North America since the early 1990s. Because of this, the prevalence of revision reverse total shoulder arthroplasty cases has continued to rise. On occasion, the need for revision of RSA can be due to and is complicated by glenoid bone loss defects, making this one of the most challenging cases for arthroplasty surgeons to perform. Historically, iliac crest or tibial grafts are most commonly used for these defects, although this comes with the disadvantage of requiring two surgical sites to be prepped and draped. The purpose of this article is to present a 1-stage technique and demonstrate the viability of distal clavicle resection for autologous grafting of large central glenoid bone loss defects in revision total shoulder arthroplasty.
Case Presentation: Our patient was a 67-year-old female who presented with concerns of right shoulder pain and limited right upper extremity range of motion in the setting of prior total shoulder arthroplasty. Despite conservative management, her symptoms persisted, and her activities of daily living were severely limited. Computed tomography (CT) and magnetic resonance imaging (MRI) were obtained and significant for aseptic hardware loosening of the glenoid baseplate. The decision was made to perform a revision RSA with distal clavicle autologous grafting for the glenoid defect.
Conclusion: For revision total shoulder arthroplasty complicated by large glenoid bone loss defects requiring grafting, distal clavicle resection for autologous grafting appears to be a viable option. At two months post-operatively, our patient had adequate glenoid baseplate fixation and healing of her humeral tuberosities. Additionally, her pain had resolved, and the range of motion in the right upper extremity had significantly improved. Although these preliminary findings are promising, further clinical studies are needed to determine the long-term outcomes and utility of the distal clavicle graft in glenoid bone loss for revision shoulder arthroplasty.
Presentation Type
Poster
Recommended Citation
Bialaszewski, Ryan; Chapel, Ross; and Gerold, Frank, "Surgical Technique for Glenoid Bone Defect in Revision Shoulder Arthroplasty: Distal Clavicle Excision and Grafting for 1-Stage Reverse Total Shoulder Prosthesis" (2024). Research Colloquium. 47.
https://scholarworks.utrgv.edu/colloquium/2023/posters/47
Included in
Surgical Technique for Glenoid Bone Defect in Revision Shoulder Arthroplasty: Distal Clavicle Excision and Grafting for 1-Stage Reverse Total Shoulder Prosthesis
Introduction: Reverse shoulder arthroplasty (RSA) has expanded its indications and use in North America since the early 1990s. Because of this, the prevalence of revision reverse total shoulder arthroplasty cases has continued to rise. On occasion, the need for revision of RSA can be due to and is complicated by glenoid bone loss defects, making this one of the most challenging cases for arthroplasty surgeons to perform. Historically, iliac crest or tibial grafts are most commonly used for these defects, although this comes with the disadvantage of requiring two surgical sites to be prepped and draped. The purpose of this article is to present a 1-stage technique and demonstrate the viability of distal clavicle resection for autologous grafting of large central glenoid bone loss defects in revision total shoulder arthroplasty.
Case Presentation: Our patient was a 67-year-old female who presented with concerns of right shoulder pain and limited right upper extremity range of motion in the setting of prior total shoulder arthroplasty. Despite conservative management, her symptoms persisted, and her activities of daily living were severely limited. Computed tomography (CT) and magnetic resonance imaging (MRI) were obtained and significant for aseptic hardware loosening of the glenoid baseplate. The decision was made to perform a revision RSA with distal clavicle autologous grafting for the glenoid defect.
Conclusion: For revision total shoulder arthroplasty complicated by large glenoid bone loss defects requiring grafting, distal clavicle resection for autologous grafting appears to be a viable option. At two months post-operatively, our patient had adequate glenoid baseplate fixation and healing of her humeral tuberosities. Additionally, her pain had resolved, and the range of motion in the right upper extremity had significantly improved. Although these preliminary findings are promising, further clinical studies are needed to determine the long-term outcomes and utility of the distal clavicle graft in glenoid bone loss for revision shoulder arthroplasty.