Total shoulder arthroplasty does not correct the orientation of the eroded glenoid.
Background and purpose Alignment of the glenoid component with the scapula during total shoulder arthroplasty (TSA) is challenging due to glenoid erosion and lack of both bone stock and guiding landmarks. We determined the extent to which the implant position is governed by the preoperative erosion...
| Publicado en: | Acta Orthopaedica Vol. 83; no. 5; pp. 529 - 536 |
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| Autores principales: | , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Medical Journals Sweden AB
Oct2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104428855&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104428855 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17453674 1BVL jtl: Acta Orthopaedica issn: 17453674 maglogo: N pubinfo: dt: Oct2012 vid: 83 iid: 5 pid: 59195 pub: Medical Journals Sweden AB artinfo: ui: 104428855 82671606 10.3109/17453674.2012.733916 NLM23083436 104428855 ppf: 529 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Total shoulder arthroplasty does not correct the orientation of the eroded glenoid. aug: au: Gregory, Thomas Hansen, Ulrich Emery, Roger Amis, Andrew A Mutchler, Celine Taillieu, Fabienne Augereau, Bernard affil: Department of Orthopaedic Surgery, University Paris Descartes, European Hospital Georges Pompidou, APHP, Paris, France; Mechanical Engineering, Imperial College London sug: subj: Arthroplasty, Replacement, Shoulder Methods Scapula Radiography Shoulder Joint Radiography Joint Prosthesis Human Tomography, X-Ray Computed Retrospective Design Scapula Pathology Shoulder Joint Pathology Data Analysis Software Funding Source ab: Background and purpose Alignment of the glenoid component with the scapula during total shoulder arthroplasty (TSA) is challenging due to glenoid erosion and lack of both bone stock and guiding landmarks. We determined the extent to which the implant position is governed by the preoperative erosion of the glenoid. Also, we investigated whether excessive erosion of the glenoid is associated with perforation of the glenoid vault. Methods We used preoperative and postoperative CT scans of 29 TSAs to assess version, inclination, rotation, and offset of the glenoid relative to the scapula plane. The position of the implant keel within the glenoid vault was classified into three types: centrally positioned, component touching vault cortex, and perforation of the cortex. Results Preoperative glenoid erosion was statistically significantly linked to the postoperative placement of the implant regarding all position parameters. Retroversion of the eroded glenoid was on average 10° (SD10) and retroversion of the implant after surgery was 7° (SD11). The implant keel was centered within the vault in 7 of 29 patients and the glenoid vault was perforated in 5 patients. Anterior cortex perforation was most frequent and was associated with severe preoperative posterior erosion, causing implant retroversion. Interpretation The position of the glenoid component reflected the preoperative erosion and 'correction' was not a characteristic of the reconstructive surgery. Severe erosion appears to be linked to vault perforation. If malalignment and perforation are associated with loosening, our results suggest reorientation of the implant relative to the eroded surface. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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