Wednesday, October 17, 2012

A case of glenoid component failure

 Here's a note just received from a colleague:

"I just saw a 64-year-old woman who had a TSA in March of 2011 by Dr X (shoulder fellowship trained).  She says it was great for a year and then she began to have vague pain that progressed to more severe pain with movement of the shoulder. She tried to go back to see Dr. X but he wouldn't see her as she changed insurance to X, which he apparently doesn't take.  So, she came to see me.  

X-rays show that her glenoid component appears to have loosened or dislodged and is sitting, with a large amount of cement on it, anteriorly and her humeral head is subluxated anteriorly as well.  She has a lot of pain and it is difficult to assess her subscap function, but it doesn't seem great.  I told her that she would very likely need a revision.  

Basically, she wants to see you to revise her shoulder and is happy to wait as long as she needs.  I gave her the info and ordered a CT scan to get a better look at her glenoid bone and the position of the components.  She's a nice woman."

What we see is a keeled glenoid inserted with a very large amount of cement. The glenoid component is out the front and there is a large amount of bone loss. 

'nuf said.


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