Original article
Glenoid bone grafting with a reverse design prosthesis

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The purpose of this study was to evaluate the outcome of patients who underwent glenoid bone grafting and implantation of a reverse design prosthesis in 1 or 2 stages for the treatment of glenoid bone loss and rotator cuff insufficiency. Indications for the reverse prosthesis in this series included cuff tear arthropathy and revision arthroplasty. Nine patients were reviewed clinically and radiographically with a minimum 2-year follow-up (range, 24-41 months). Despite a low postoperative functional score (mean Constant score, 53 points [range, 22-79 points]), most patients were satisfied with their results primarily because of pain relief. (The mean pain score increased from 3 points preoperatively to 12.5 points postoperatively.) Radiographic evaluation did not demonstrate component loosening or evidence of graft failure. Six patients had radiographic evidence of an inferior scapular notch, which may be of concern in the future. Early results of this procedure are encouraging, but further clinical and radiologic assessment is necessary.

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Materials and methods

Two hundred thirty-five consecutive patients were treated from September 1995 to June 2003 with a Grammont reverse design prosthesis (DePuy France, Saint Priest, France). Indications for treatment included cuff tear arthropathy (54 cases), glenohumeral osteoarthritis (44 cases), posttraumatic arthritis (31 cases), failure of rotator cuff surgery (25 cases), massive rotator cuff tear without arthritis (19 cases), rheumatoid arthritis (5 cases), fractures (3 cases), tumors (2 cases), and revision

Results

Follow-up averaged 31 months (range, 24-41 months). Results of the preoperative and postoperative clinical evaluations are shown in Table I. The mean score for pain for the entire series increased from 3 to 12.5 points (out of 15 points possible). Only 1 patient complained of significant pain (case 8). This patient had pain in the shoulder that was further complicated by a history of multiple cervical spine operations. Five patients were completely pain-free at the latest follow-up visit.

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Discussion

Many conditions of the shoulder may be complicated by glenoid bone deficiency or rotator cuff deficiency, such as cuff tear arthropathy, primary glenohumeral osteoarthritis, posttraumatic arthritis, failed rotator cuff surgery, massive rotator cuff tear with pseudoparalysis, rheumatoid arthritis, fractures, and tumors. In addition, shoulders that have previously undergone arthroplasty for these conditions may develop glenoid bone deficiency after either loosening of a glenoid component or

References (25)

  • L. Favard et al.

    La prothèse inversée de Grammont dans le traitement des arthropathies de l’épaule à coiffe détruiteRésultats d’une série multicentrique de 42 cas

    Rev Chir Orthop

    (1998)
  • J. Fenlin

    Semi-constrained prosthesis for the rotator cuff deficient patient

    Orthop Trans

    (1985)
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