There is a lot to be learned about evaluation and management of the arthritic glenoid as shown in a recent article. In this article the x-rays below illustrate some of these. The figure below shows the implantation of a 7 mm posteriorly augmented glenoid component 'recommended' by a three dimensional imaging and templating system. Note that this implantation requires removal of about half of the dense bone in the posterior glenoid.
This bone removal is also shown in the figures below copyrighted by Steve Lippitt comparing the bone loss with the StepTech to that of the conservative glenoid reaming approach that we embrace (using anteriorly augmented humeral head components and rotator interval plication if necessary to manage posterior instability).
It is apparent that if a stepped posterior glenoid component fails, the bone loss will greatly complicate any additional reconstruction.
Here are the eccentric heads used in conduction with conservative reaming.
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