Tuesday, December 18, 2012

Retroverted glenoid - failure of total shoulder

Total shoulder arthroplasty is viewed by many surgeons as the 'gold standard' for the treatment of glenohumeral arthritis. There are some situations, however, in which eccentric forces on the glenoid component predispose the reconstruction to failure from rocking horse loosening.

Here is the preoperative axillary view of a patient from Arkansas with glenoid retroversion and posterior displacement of the humeral head relative to the glenoid.

A total shoulder was performed by his surgeon there. Note that there was an attempt to 'normalize' the glenoid version by the addition of cement beneath the posterior aspect of the glenoid component. The cementation technique was excellent, but the tendency of the humeral head to ride posteriorly is seen on this postoperative film.

The glenoid component ultimately failed by rocking horse loosening.

 Because of concern for this type of glenoid component failure, we use a different approach to glenoid retroversion.


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