Sunday, January 19, 2014

shoulder joint replacement arthroplasty for dysplasia

Shoulder arthroplasty for osteoarthritis secondary to glenoid dysplasia: an update.

Shoulder dysplasia is an important condition to recognize and a difficult condition to treat because of the posterior glenoid bone deficiency. It results from failure of development of the inferior ossification center of the glenoid fossa. 

These authors performed 8 hemiarthroplasties and 14 total shoulder arthroplasties for shoulders with osteoarthritis secondary to glenoid dysplasia. Average follow-up was 6 years (range, 0.4 to 23.1 years).

Nine cases required revision surgery. Four shoulders having hemiarthroplasty underwent revision surgery because of painful glenoid arthrosis. Two shoulders with total arthroplasty underwent revision for infection, and 3 underwent revision for glenoid component issues.
The authors concluded that continuing subluxation, glenoid arthrosis, and glenoid component problems necessitating revision surgery are risks attending shoulder arthroplasty for this condition.

Comment: Patients with dysplasia may present with symptoms of posterior instability suggesting labral deficiency as well as with secondary arthritis. In either situation, surgical reconstruction carries a high failure risk.