Treatment of severe glenoid deficiencies in reverse shoulder arthroplasty: the Glenius Glenoid Reconstruction System experience

J Shoulder Elbow Surg. 2019 Aug;28(8):1601-1608. doi: 10.1016/j.jse.2018.11.061. Epub 2019 Feb 13.

Abstract

Background: The treatment of glenoid bone deficiencies in primary or revision total shoulder arthroplasty is challenging. This retrospective study evaluated the short-term clinical and radiologic results of a new custom-made patient-specific glenoid implant.

Methods: We treated 10 patients with severe glenoid deficiencies with the Glenius Glenoid Reconstruction System (Materialise NV, Leuven, Belgium). Outcome data included a patient-derived Constant-Murley score, a visual analog score (VAS), a satisfaction score, the 11-item version of the Disabilities of the Arm, Shoulder and Hand score, and the Simple Shoulder Test. We compared the postoperative position of the implant with the preoperative planned position on computed tomography scans.

Results: At an average follow-up period of 30.5 months, the mean patient-derived Constant-Murley score was 41.3 ± 17.5 points (range, 18-76 points) with a visual analog scale of 3.3 ± 2.5 points (range, 0-7 points). The mean 11-item version of the Disabilities of the Arm, Shoulder and Hand score was 35.8 ± 18.4 (range, 2-71), and the mean Simple Shoulder Test was 47.5% ± 25.3% (range, 8%-92%). Eight patients reported the result as better (n = 3) or much better (n = 5). One patient had an elongation of the brachial plexus, and 1 patient had a period of instability. The average preoperative glenoid defect size was 9 ± 4 cm3 (range, 1-14 cm3). The mean deviation between the preoperative planned and the postoperative version and inclination was 6° ± 4° (range 1°-16°) and 4° ± 4° (range 0°-11°), respectively.

Conclusion: Early results of the Glenius Glenoid Reconstruction System are encouraging. Adequate pain relief, a reasonable functionality, and good patient satisfaction can be obtained in these difficult cases. Further follow-up will determine the bony ingrowth and subsequent longevity of this patient-specific glenoid component.

Keywords: Reverse shoulder arthroplasty; augmented glenoid components; custom-made patient-specific shoulder implant; glenoid deficiency; inclination and version angle; reverse shoulder arthroplasty.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Shoulder / instrumentation*
  • Female
  • Humans
  • Joint Instability / diagnosis
  • Joint Instability / physiopathology
  • Joint Instability / surgery*
  • Male
  • Middle Aged
  • Postoperative Period
  • Range of Motion, Articular / physiology*
  • Retrospective Studies
  • Severity of Illness Index
  • Shoulder Joint / diagnostic imaging
  • Shoulder Joint / physiopathology
  • Shoulder Joint / surgery*
  • Tomography, X-Ray Computed
  • Treatment Outcome