Radiographic and clinical outcomes of primary anatomic total shoulder arthroplasty with glenoid bone grafting: a case series

Abstract

BackgroundGlenoid bone grafting is an option to correct severe glenoid retroversion and posterior bone loss in the setting of primary total shoulder arthroplasty (TSA). However, limited studies report the midterm outcomes of this procedure. MethodsThis was a retrospective case series of patients undergoing TSA with an autologous humeral head glenoid bone graft by a single surgeon between 2004 and 2014. Outcome variables included preoperative and postoperative forward elevation, external rotation, internal rotation, visual analog scale score, American Shoulder and Elbow Surgeons score, and simple shoulder test score. Radiographic variables included the acromiohumeral interval and Lazarus glenoid loosening score. ResultsIn total, 7 cases were included in our analysis. The mean age was 65.0 years (range 55-80), and the mean follow-up was 6.8 years (range 4.2-8.2). All patients had a diagnosis of osteoarthritis as the primary indication for surgery. The glenoid implant types were 2 pegged (28.6%) and 5 keeled (71.4%). The Walch glenoid classifications were 3 B2 (42.9%), 1 B3 (14.3%), and 3 with unavailable preoperative computed tomography scans (42.9%). Mean forward elevation, external rotation, visual analog scale, and American Shoulder and Elbow Surgeons all improved significantly from preoperative to postoperative. Mean internal rotation and simple shoulder test trended toward improvement. Radiographic glenoid loosening was observed in 1 patient, and 1 patient underwent revision to reverse TSA due to graft resorption and glenoid loosening at 8.3 years following the index procedure. ConclusionGlenoid bone grafting is a viable option for patients requiring TSA with severe glenoid retroversion and posterior bone loss. Graft resorption and glenoid loosening remain concerns; however, the majority of patients in our study demonstrated significant improvement following their procedure.