title: Outcomes after shoulder arthroplasty revision with glenoid reconstruction and bone grafting.
abstract: OBJECTIVE
  Extensive glenoid bone loss after failed shoulder arthroplasty represents a challenge for revision arthroplasty. Treatment options vary widely and have been a source of controversy among experts.
  
  
  METHODS
  Between 2004 and 2010, a total of 17 patients underwent glenoid reconstruction surgery using an autologous iliac crest bone graft and secondary revision arthroplasty due to extensive glenoid bone loss after failed previous total shoulder arthroplasty. The outcomes were assessed by means of clinical examination, Constant score, and bi-plane radiography as well as pre-, postoperative and follow-up CT.
  
  
  RESULTS
  Before the revision surgery, the mean Constant score was 24 ± 17 and improved to 40 ± 13 after the glenoid rebuilding and revision arthroplasty. CT imaging revealed adequate glenoid bone stock restoration with no relevant graft resorption or loosening of the glenoid. The average postoperative antero-posterior diameter of the glenoid was 28 ± 3 mm which had decreased to 25 ± 3 mm at follow-up. The average postoperative version of the glenoid was 95.7° ± 6° and had decreased to 98.5° ± 4° at follow-up. Both the glenoid version and diameter had changed significantly (P < 0.001) comparing postoperative and follow-up CT-scans.
  
  
  CONCLUSIONS
  Glenoid reconstruction surgery using an iliac crest bone-block autograft prior to revision arthroplasty represents a valuable salvage procedure in cases of extensive glenoid bone loss after primary shoulder arthroplasty. Sufficient glenoid bone stock restoration is indispensable for reliable fixation of glenoid components and in turn a satisfactory clinical outcome.
authors: Department of Traumatology and Sports Injuries, Paracelsus Medical University Salzburg, Muellner Hauptstrasse 48, 5020, Salzburg, Austria, t.hoffelner@salk.at.
authors: Thomas
authors: T
authors: Hoffelner
authors: Philipp
authors: P
authors: Moroder
authors: Alexander
authors: A
authors: Auffarth
authors: Mark
authors: M
authors: Tauber
authors: Herbert
authors: H
authors: Resch
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement / Q000379:methods*; D064592:Autografts; D001365:Axilla / Q000000981:diagnostic imaging; D016025:Bone Transplantation; D005260:Female; D061165:Glenoid Cavity / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012785:Shoulder Joint / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome