Metal glenoid augmentation in revision arthroplasty

Abstract

Glenoid implantation in revision arthroplasty of the shoulder remains atechnical challenge in the case of severe bone loss. Metal glenoid augmentation and patient-specific glenoid implants represent new treatment options with great potential. Virtual planning techniques allow adifferentiated evaluation of the extent of the bone loss and the planning of different augmentation options. Although not clearly defined so far, apatient-specific implant can be indicated if adequate fixation of the base plate in the native bone appears questionable. The planning is carried out with the support of the prostheses manufacturer and the stability is simulated using finite element analysis. Ahigh level of primary stability is achieved by an optimized fitting of the implant into the bony defect. The short-term results are promising. However, in the absence of long-term results and limited options in case of revision, the use of acustom-made glenoid warrants astrict indication.