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Anatomic Shoulder Arthroplasty in the Setting of Glenoid Bony Erosion (Walch B2-, B3-, and C-Type Glenoids)

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Abstract

Anatomic total shoulder arthroplasty (TSA) has been shown to be a reliable surgery for pain relief, improvement of shoulder function, and quality of life. The presence of biconcave glenoid deformity poses a significant reconstructive challenge for a shoulder surgeon as this deformity has been associated with poorer clinical outcomes and a higher rate of complications. Reconstructive options are largely dictated by the severity of the glenoid deformity and the degree of preoperative humeral head subluxation; however, other factors such as patient age and activity level and rotator cuff muscle health must be considered in choosing the optimal treatment option for these patients.

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References

  1. Walch G, Badet R, Boulahia A, Khoury A. Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplast. 1999;14(6):756–60.

    Article  CAS  Google Scholar 

  2. Badet R, Walch G, Boulahia A. Computed tomography in primary glenohumeral osteoarthritis without humeral head elevation. Rev Rhum Engl Ed. 1998;65(3):187–94.

    CAS  PubMed  Google Scholar 

  3. Churchill RS, Spencer EE Jr, Fehringer EV. Quantification of B2 glenoid morphology in total shoulder arthroplasty. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2015;24(8):1212–7.

    Article  Google Scholar 

  4. Hoenecke HR Jr, Tibor LM, D'Lima DD. Glenoid morphology rather than version predicts humeral subluxation: a different perspective on the glenoid in total shoulder arthroplasty. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2012;21(9):1136–41.

    Article  Google Scholar 

  5. Gerber C, Costouros JG, Sukthankar A, Fucentese SF. Static posterior humeral head subluxation and total shoulder arthroplasty. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2009;18(4):505–10.

    Article  Google Scholar 

  6. Ricchetti ET, Hendel MD, Collins DN, Iannotti JP. Is premorbid glenoid anatomy altered in patients with glenohumeral osteoarthritis? Clin Orthop Relat Res. 2013;471(9):2932–9.

    Article  Google Scholar 

  7. Iannotti JP, Jun BJ, Patterson TE, Ricchetti ET. Quantitative measurement of osseous pathology in advanced glenohumeral osteoarthritis. J Bone Joint Surg Am. 2017;99(17):1460–8.

    Article  Google Scholar 

  8. Knowles NK, Ferreira LM, Athwal GS. Premorbid retroversion is significantly greater in type B2 glenoids. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2016;25(7):1064–8.

    Article  Google Scholar 

  9. Walch G, Ascani C, Boulahia A, Nove-Josserand L, Edwards TB. Static posterior subluxation of the humeral head: an unrecognized entity responsible for glenohumeral osteoarthritis in the young adult. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2002;11(4):309–14.

    Article  Google Scholar 

  10. Domos P, Checchia CS, Walch G. Walch B0 glenoid: pre-osteoarthritic posterior subluxation of the humeral head. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2018;27(1):181–8.

    Article  Google Scholar 

  11. Bryce CD, Davison AC, Lewis GS, Wang L, Flemming DJ, Armstrong AD. Two-dimensional glenoid version measurements vary with coronal and sagittal scapular rotation. J Bone Joint Surg Am. 2010;92(3):692–9.

    Article  Google Scholar 

  12. Chalmers PN, Salazar D, Chamberlain A, Keener JD. Radiographic characterization of the B2 glenoid: the effect of computed tomographic axis orientation. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2017;26(2):258–64.

    Article  Google Scholar 

  13. Budge MD, Lewis GS, Schaefer E, Coquia S, Flemming DJ, Armstrong AD. Comparison of standard two-dimensional and three-dimensional corrected glenoid version measurements. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2011;20(4):577–83.

    Article  Google Scholar 

  14. Hoenecke HR Jr, Hermida JC, Flores-Hernandez C, D'Lima DD. Accuracy of CT-based measurements of glenoid version for total shoulder arthroplasty. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2010;19(2):166–71.

    Article  Google Scholar 

  15. Iannotti JP, Weiner S, Rodriguez E, Subhas N, Patterson TE, Jun BJ, et al. Three-dimensional imaging and templating improve glenoid implant positioning. J Bone Joint Surg Am. 2015;97(8):651–8.

    Article  Google Scholar 

  16. Walch G, Vezeridis PS, Boileau P, Deransart P, Chaoui J. Three-dimensional planning and use of patient-specific guides improve glenoid component position: an in vitro study. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2015;24(2):302–9.

    Article  Google Scholar 

  17. Throckmorton TW, Gulotta LV, Bonnarens FO, Wright SA, Hartzell JL, Rozzi WB, et al. Patient-specific targeting guides compared with traditional instrumentation for glenoid component placement in shoulder arthroplasty: a multi-surgeon study in 70 arthritic cadaver specimens. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2015;24(6):965–71.

    Article  Google Scholar 

  18. Iannotti J, Baker J, Rodriguez E, Brems J, Ricchetti E, Mesiha M, et al. Three-dimensional preoperative planning software and a novel information transfer technology improve glenoid component positioning. J Bone Joint Surg Am. 2014;96(9):e71.

    Article  Google Scholar 

  19. Hendel MD, Bryan JA, Barsoum WK, Rodriguez EJ, Brems JJ, Evans PJ, et al. Comparison of patient-specific instruments with standard surgical instruments in determining glenoid component position: a randomized prospective clinical trial. J Bone Joint Surg Am. 2012;94(23):2167–75.

    Article  Google Scholar 

  20. Kircher J, Wiedemann M, Magosch P, Lichtenberg S, Habermeyer P. Improved accuracy of glenoid positioning in total shoulder arthroplasty with intraoperative navigation: a prospective-randomized clinical study. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2009;18(4):515–20.

    Article  Google Scholar 

  21. Knowles NK, Keener JD, Ferreira LM, Athwal GS. Quantification of the position, orientation, and surface area of bone loss in type B2 glenoids. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2015;24(4):503–10.

    Google Scholar 

  22. Beuckelaers E, Jacxsens M, Van Tongel A, De Wilde LF. Three-dimensional computed tomography scan evaluation of the pattern of erosion in type B glenoids. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2014;23(1):109–16.

    Article  Google Scholar 

  23. Sabesan V, Callanan M, Sharma V, Iannotti JP. Correction of acquired glenoid bone loss in osteoarthritis with a standard versus an augmented glenoid component. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2014;23(7):964–73.

    Article  Google Scholar 

  24. Knowles NK, Athwal GS, Keener JD, Ferreira LM. Regional bone density variations in osteoarthritic glenoids: a comparison of symmetric to asymmetric (type B2) erosion patterns. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2015;24(3):425–32.

    Google Scholar 

  25. Sabesan VJ, Callanan M, Youderian A, Iannotti JP. 3D CT assessment of the relationship between humeral head alignment and glenoid retroversion in glenohumeral osteoarthritis. J Bone Joint Surg Am. 2014;96(8):e64.

    Article  Google Scholar 

  26. Chan K, Knowles NK, Chaoui J, Gauci MO, Ferreira LM, Walch G, et al. Characterization of the Walch B3 glenoid in primary osteoarthritis. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2017;26(5):909–14.

    Article  Google Scholar 

  27. Bercik MJ, Kruse K 2nd, Yalizis M, Gauci MO, Chaoui J, Walch G. A modification to the Walch classification of the glenoid in primary glenohumeral osteoarthritis using three-dimensional imaging. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2016;25(10):1601–6.

    Article  Google Scholar 

  28. Knowles NK, Carroll MJ, Keener JD, Ferreira LM, Athwal GS. A comparison of normal and osteoarthritic humeral head size and morphology. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2016;25(3):502–9.

    Article  Google Scholar 

  29. Iannotti JP, Spencer EE, Winter U, Deffenbaugh D, Williams G. Prosthetic positioning in total shoulder arthroplasty. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2005;14(1 Suppl S):111S–21S.

    Article  Google Scholar 

  30. Shapiro TA, McGarry MH, Gupta R, Lee YS, Lee TQ. Biomechanical effects of glenoid retroversion in total shoulder arthroplasty. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2007;16(3 Suppl):S90–5.

    Article  Google Scholar 

  31. Farron A, Terrier A, Buchler P. Risks of loosening of a prosthetic glenoid implanted in retroversion. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2006;15(4):521–6.

    Article  Google Scholar 

  32. Nyffeler RW, Sheikh R, Atkinson TS, Jacob HA, Favre P, Gerber C. Effects of glenoid component version on humeral head displacement and joint reaction forces: an experimental study. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2006;15(5):625–9.

    Article  Google Scholar 

  33. Terrier A, Buchler P, Farron A. Influence of glenohumeral conformity on glenoid stresses after total shoulder arthroplasty. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2006;15(4):515–20.

    Article  Google Scholar 

  34. Mansat P, Briot J, Mansat M, Swider P. Evaluation of the glenoid implant survival using a biomechanical finite element analysis: influence of the implant design, bone properties, and loading location. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2007;16(3 Suppl):S79–83.

    Article  CAS  Google Scholar 

  35. Hopkins AR, Hansen UN, Amis AA, Emery R. The effects of glenoid component alignment variations on cement mantle stresses in total shoulder arthroplasty. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2004;13(6):668–75.

    Article  Google Scholar 

  36. Yongpravat C, Kim HM, Gardner TR, Bigliani LU, Levine WN, Ahmad CS. Glenoid implant orientation and cement failure in total shoulder arthroplasty: a finite element analysis. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2013;22(7):940–7.

    Article  Google Scholar 

  37. Ho JC, Sabesan VJ, Iannotti JP. Glenoid component retroversion is associated with osteolysis. J Bone Joint Surg Am. 2013;95(12):e82.

    Article  Google Scholar 

  38. Walch G, Moraga C, Young A, Castellanos-Rosas J. Results of anatomic nonconstrained prosthesis in primary osteoarthritis with biconcave glenoid. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2012;21(11):1526–33.

    Article  Google Scholar 

  39. Spencer EE Jr, Valdevit A, Kambic H, Brems JJ, Iannotti JP. The effect of humeral component anteversion on shoulder stability with glenoid component retroversion. J Bone Joint Surg Am. 2005;87(4):808–14.

    Article  Google Scholar 

  40. Yongpravat C, Lester JD, Saifi C, Trubelja A, Greiwe RM, Bigliani LU, et al. Glenoid morphology after reaming in computer-simulated total shoulder arthroplasty. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2013;22(1):122–8.

    Article  Google Scholar 

  41. Chen X, Reddy AS, Kontaxis A, Choi DS, Wright T, Dines DM, et al. Version correction via eccentric reaming compromises remaining bone quality in B2 glenoids: a computational study. Clin Orthop Relat Res. 2017;475(12):3090–9.

    Article  Google Scholar 

  42. Clavert P, Millett PJ, Warner JJ. Glenoid resurfacing: what are the limits to asymmetric reaming for posterior erosion? J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2007;16(6):843–8.

    Google Scholar 

  43. Gillespie R, Lyons R, Lazarus M. Eccentric reaming in total shoulder arthroplasty: a cadaveric study. Orthopedics. 2009;32(1):21.

    Article  Google Scholar 

  44. Iannotti JP, Greeson C, Downing D, Sabesan V, Bryan JA. Effect of glenoid deformity on glenoid component placement in primary shoulder arthroplasty. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2012;21(1):48–55.

    Article  Google Scholar 

  45. Nowak DD, Bahu MJ, Gardner TR, Dyrszka MD, Levine WN, Bigliani LU, et al. Simulation of surgical glenoid resurfacing using three-dimensional computed tomography of the arthritic glenohumeral joint: the amount of glenoid retroversion that can be corrected. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2009;18(5):680–8.

    Article  Google Scholar 

  46. Wang T, Abrams GD, Behn AW, Lindsey D, Giori N, Cheung EV. Posterior glenoid wear in total shoulder arthroplasty: eccentric anterior reaming is superior to posterior augment. Clin Orthop Relat Res. 2015;473(12):3928–36.

    Article  Google Scholar 

  47. Kim HM, Chacon AC, Andrews SH, Roush EP, Cho E, Conaway WK, et al. Biomechanical benefits of anterior offsetting of humeral head component in posteriorly unstable total shoulder arthroplasty: a cadaveric study. J Orthop Res. 2016;34(4):666–74.

    Article  Google Scholar 

  48. Hsu JE, Gee AO, Lucas RM, Somerson JS, Warme WJ, Matsen FA 3rd. Management of intraoperative posterior decentering in shoulder arthroplasty using anteriorly eccentric humeral head components. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2016;25(12):1980–8.

    Article  Google Scholar 

  49. Knowles NK, Ferreira LM, Athwal GS. Augmented glenoid component designs for type B2 erosions: a computational comparison by volume of bone removal and quality of remaining bone. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2015;24(8):1218–26.

    Article  Google Scholar 

  50. Kersten AD, Flores-Hernandez C, Hoenecke HR, D’Lima DD. Posterior augmented glenoid designs preserve more bone in biconcave glenoids. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2015;24(7):1135–41.

    Article  Google Scholar 

  51. Allred JJ, Flores-Hernandez C, Hoenecke HR Jr, D'Lima DD. Posterior augmented glenoid implants require less bone removal and generate lower stresses: a finite element analysis. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2016;25(5):823–30.

    Article  Google Scholar 

  52. Hermida JC, Flores-Hernandez C, Hoenecke HR, D'Lima DD. Augmented wedge-shaped glenoid component for the correction of glenoid retroversion: a finite element analysis. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2014;23(3):347–54.

    Article  Google Scholar 

  53. Iannotti JP, Lappin KE, Klotz CL, Reber EW, Swope SW. Liftoff resistance of augmented glenoid components during cyclic fatigue loading in the posterior-superior direction. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2013;22(11):1530–6.

    Article  Google Scholar 

  54. Iannotti JP, Norris TR. Influence of preoperative factors on outcome of shoulder arthroplasty for glenohumeral osteoarthritis. J Bone Joint Surg Am. 2003;85-A(2):251–8.

    Article  Google Scholar 

  55. McLendon PB, Schoch BS, Sperling JW, Sanchez-Sotelo J, Schleck CD, Cofield RH. Survival of the pegged glenoid component in shoulder arthroplasty: part II. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2017;26(8):1469–76.

    Google Scholar 

  56. Habermeyer P, Magosch P, Lichtenberg S. Recentering the humeral head for glenoid deficiency in total shoulder arthroplasty. Clin Orthop Relat Res. 2007;457:124–32.

    Google Scholar 

  57. Service BC, Hsu JE, Somerson JS, Russ SM, Matsen FA 3rd. Does postoperative glenoid retroversion affect the 2-year clinical and radiographic outcomes for total shoulder arthroplasty? Clin Orthop Relat Res. 2017;475(11):2726–39.

    Article  Google Scholar 

  58. Orvets ND, Chamberlain AM, Patterson BM, Chalmers PN, Gosselin M, Salazar D, et al. Total shoulder arthroplasty in patients with a B2 glenoid addressed with corrective reaming. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2018;27(6S):S58–64.

    Article  Google Scholar 

  59. Neer CS 2nd, Morrison DS. Glenoid bone-grafting in total shoulder arthroplasty. J Bone Joint Surg Am. 1988;70(8):1154–62.

    Article  Google Scholar 

  60. Steinmann SP, Cofield RH. Bone grafting for glenoid deficiency in total shoulder replacement. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2000;9(5):361–7.

    Article  CAS  Google Scholar 

  61. Klika BJ, Wooten CW, Sperling JW, Steinmann SP, Schleck CD, Harmsen WS, et al. Structural bone grafting for glenoid deficiency in primary total shoulder arthroplasty. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2014;23(7):1066–72.

    Article  Google Scholar 

  62. Sabesan V, Callanan M, Ho J, Iannotti JP. Clinical and radiographic outcomes of total shoulder arthroplasty with bone graft for osteoarthritis with severe glenoid bone loss. J Bone Joint Surg Am. 2013;95(14):1290–6.

    Article  Google Scholar 

  63. Nicholson GP, Cvetanovich GL, Rao AJ, O'Donnell P. Posterior glenoid bone grafting in total shoulder arthroplasty for osteoarthritis with severe posterior glenoid wear. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2017;26(10):1844–53.

    Article  Google Scholar 

  64. Rice RS, Sperling JW, Miletti J, Schleck C, Cofield RH. Augmented glenoid component for bone deficiency in shoulder arthroplasty. Clin Orthop Relat Res. 2008;466(3):579–83.

    Article  Google Scholar 

  65. Cil A, Sperling JW, Cofield RH. Nonstandard glenoid components for bone deficiencies in shoulder arthroplasty. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2014;23(7):e149–57.

    Article  Google Scholar 

  66. Stephens SP, Spencer EE, Wirth MA. Radiographic results of augmented all-polyethylene glenoids in the presence of posterior glenoid bone loss during total shoulder arthroplasty. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2017;26(5):798–803.

    Article  Google Scholar 

  67. Favorito PJ, Freed RJ, Passanise AM, Brown MJ. Total shoulder arthroplasty for glenohumeral arthritis associated with posterior glenoid bone loss: results of an all-polyethylene, posteriorly augmented glenoid component. J Shoulder Elbow Surg/American Shoulder and Elbow Surgeons [et al]. 2016;25(10):1681–9.

    Article  Google Scholar 

  68. Wright TW, Grey SG, Roche CP, Wright L, Flurin PH, Zuckerman JD. Preliminary results of a posterior augmented glenoid compared to an all polyethylene standard glenoid in anatomic total shoulder arthroplasty. Bull Hosp Jt Dis (2013). 2015;73(Suppl 1):S79–85.

    Google Scholar 

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Correspondence to Jay D. Keener .

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Keener, J.D. (2019). Anatomic Shoulder Arthroplasty in the Setting of Glenoid Bony Erosion (Walch B2-, B3-, and C-Type Glenoids). In: Tashjian, R. (eds) Complex and Revision Shoulder Arthroplasty . Springer, Cham. https://doi.org/10.1007/978-3-030-02756-8_4

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  • DOI: https://doi.org/10.1007/978-3-030-02756-8_4

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