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Scientific Articles   |    
Clinical and Radiographic Outcomes of Total Shoulder Arthroplasty with Bone Graft for Osteoarthritis with Severe Glenoid Bone Loss
Vani Sabesan, MD1; Mark Callanan, MA2; Jason Ho, MS3; Joseph P. Iannotti, MD, PhD3
1 Department of Orthopaedic Surgery, MSU/KCMS, 1000 Oakland Drive, Kalamazoo, MI 49008. E-mail address: sabes001@gmail.com
2 321 Michigan Place NE, Grand Rapids, MI 49503
3 Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195
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Investigation performed at the Cleveland Clinic, Cleveland, Ohio



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2013 Jul 17;95(14):1290-1296. doi: 10.2106/JBJS.L.00097
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Abstract

Background: 

Glenohumeral osteoarthritis may be associated with severe posterior glenoid bone loss and glenoid retroversion. Treatment with total shoulder arthroplasty and autologous bone graft obtained from the humeral head has been infrequently reported in the peer-reviewed literature.

Methods: 

The clinical and radiographic results of primary total shoulder replacement with an all-polyethylene glenoid component and autologous humeral head graft augmentation performed by a single surgeon in thirteen consecutive patients were evaluated.

Results: 

Twelve of the thirteen patients were followed for a minimum of two years (average, fifty-three months; range, twenty-six to 110 months). The average glenoid retroversion on preoperative computed tomography (CT) scans was 44° (range, 20° to 65°). Based on the Walch classification of pathologic glenoid morphology, nine glenoids were B2 and three were type C. All patients had an intact cuff at the time of surgery. At the time of the last follow up, ten of the twelve patients had graft incorporation without any resorbtion and two had minor bone graft resorption. Broken screws occurred in two of these ten cases. Two patients, both of whom required revision surgery, had failure of fixation and of graft incorporation; one of these failures was due to early postoperative trauma and the other, to Propionibacterium acnes infection.

Conclusions: 

The early and midterm results of total shoulder arthroplasty with autogenous bone graft demonstrated substantial clinical and radiographic improvement in most cases.

Level of Evidence: 

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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