Tuesday, July 1, 2014

Ream and run with RIP and eccentric head for a B1 glenoid recognized on a standardized axillary view

The arthritis shown on this anteroposterior x-ray doesn't look that bad, but the patient reported that he could perform only 2 of the 12 functions of the Simple Shoulder Test.

However, the axillary view (or 'truth view') shows the glenoid retroversion and the large amount of posterior subluxation of the humeral head on the glenoid a B1 anatomy.

At surgery today we found the humeral head and the posterior glenoid were denuded of cartilage. We performed a ream and run with a 52+2 glenoid reamer, a 52 21 anteriorly eccentric humeral head and a rotator interval plication. Here are the postoperative films.

Note the centering of the humeral head in the new glenoid concavity and that there was not a substantial change in glenoid version.

Comment: This option for managing the arthritic triad eliminates the risk of wear or loosening of a plastic glenoid component or failure of a posterior bone graft.


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