Sunday, May 1, 2016

Total shoulder outcomes - B2 glenoids.


Predictors for satisfaction after anatomic total shoulder arthroplasty for idiopathic glenohumeral osteoarthritis

These authors reviewed 80 of 95 shoulders having total shoulder arthroplasty (TSA) for primary glenohumeral osteoarthritis at a mean of 3 years (range 2–9). These cases were performed by an individual surgeon working in Vail, Colorado who performed 132 TSAs between December 2005 and January 2013. The patients were overall healthy and active as reflected by their ASA and SF 36 PCS data



In patients with a B2 glenoid, the glenoid was eccentrically reamed to achieve a flat plane and essentially convert the B2 situation to a B1 situation (subluxation without biconcave glenoid). Bone grafting was not used in any case. Here is the example provided for a B2 glenoid

and here are their outcome data by glenoid type (we think they meant to include the B1s only in the right hand group). 







Three complications (3 %) and 2 failures (2 %) occurred.
They concluded that outcomes after TSA for type B glenoid morphology with posterior subluxation were similar to outcomes after TSA for centered type A morphology. Overall patient satisfaction was high and was not influenced by the demographic, anatomic, and surgical variables investigated.

Comment: This study presents the results of total shoulder arthroplasty performed by a high volume surgeon for primary osteoarthritis in generally healthy patients. In this specialized circumstance, the authors did not identify any predictors for satisfaction after anatomic total shoulder arthroplasty for idiopathic glenohumeral osteoarthritis. It is of particular interest that the glenoid type did not appear to influence the outcome and that the authors did not use special glenoid components to manage type B2 pathoanatomy.


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