The dysplastic shoulder - hemiarthroplasty without attempt to change glenoid version

We had the opportunity to care for a 60 year old patient with a painful dysplastic shoulder. At the time of presentation the patient could perform only 3 of the 12 functions of the Simple Shoulder Test. The preoperative films are shown here

While some surgeons may have considered a total shoulder with a posteriorly augmented glenoid component, a posterior bone graft or a reverse total shoulder, we offered her a hemiarthoplasty with soft tissue balancing. No CT scans were needed to plan this surgery. No attempt was made to change glenoid version.

Two years after surgery, her SST score has improved to 9 out of 12. Her two year x-rays (below) show an impaction grafted hemiarthroplasty centered on a remodeled bony glenoid.

This conservative approach has provided a robust reconstruction and preserved bone stock so that revision could be carried out should it become necessary. For now, she feels that her shoulder continues to improve with time.
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