Reconstruction of massive uncontained glenoid defects using a combined autograft-allograft construct with reverse shoulder arthroplasty: preliminary results. JSES

Reconstruction of massive uncontained glenoid defects using a combined autograft-allograft construct with reverse shoulder arthroplasty: preliminary results. This article provides a useful approach for managing severe glenoid bone loss in the performance of a reverse total shoulder. They have taken the innovative step of using a ring of femoral neck allograft to help support the base plate and to contain autograft cancellous bone within. This method enables the surgeon to customize the graft to accommodate asymmetric glenoid defects.  In the five cases they reported, the grafts united.

In the application of this method, it seems important to (1) assure a solid contact between the graft and the residual glenoid bone and (2) to robustly compress the graft into the bone using secure screw placement in the patient's scapula.

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