title: Total shoulder arthroplasty using trabecular metal augments to address glenoid retroversion: the preliminary result of 10 patients with minimum 2-year follow-up.
abstract: BACKGROUND
  Options to address glenoid retroversion include eccentric reaming, bone grafting, modifications to component shape, and reverse shoulder arthroplasty. Trabecular metal (TM) augments have been used extensively in the hip and knee to address bone deficiency in arthroplasty as part of a hybrid combination of high-density polyethylene, polymethyl methacrylate, and TM. This study presents the initial results of the use of specifically designed augments in the shoulder to address glenoid retroversion as part of total shoulder arthroplasty (TSA).
  
  
  METHODS
  Ten patients (4 women and 6 men; aged 60 to 79 years) with Walch grade B2 or C glenoids have undergone TM glenoid augment insertion as part of a TSA, with a longer than 24-month follow-up. Patients received a 15° or 30° TM wedge to correct excessive glenoid retroversion before the glenoid component was cemented. Outcome analysis was performed preoperatively, at 3, 6, and 12 months, and yearly thereafter.
  
  
  RESULTS
  All patients have been satisfied, and all scores have improved. There have been no complications and no hardware failures or displacement. All glenoid components were implanted to within 10° of neutral glenoid version. Radiographs at 24 months show good incorporation of the TM augment and the glenoid component.
  
  
  CONCLUSIONS
  The TM augments have the advantage of immediate secure fixation, no tendency to collapse, and the ability to correct retroversion of 25° or more. This study confirms the successful short-term outcome of wedge-shaped TM augments to correct glenoid retroversion as part of TSA.
authors: Royal Adelaide Hospital & Wakefield Orthopaedic Clinic, Adelaide, SA, Australia. Electronic address: msandow@woc.com.au.
authors: Michael
authors: M
authors: Sandow
authors: Royal Adelaide Hospital & Wakefield Orthopaedic Clinic, Adelaide, SA, Australia.
authors: Christine
authors: C
authors: Schutz
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement; D001672:Biocompatible Materials; D001862:Bone Resorption / Q000601:surgery*; D060751:Bone Retroversion / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008670:Metals; D008875:Middle Aged; D019736:Prostheses and Implants; D012540:Scapula / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D025321:Surgery, Computer-Assisted
chemical_list: D001672:Biocompatible Materials; D008670:Metals
keywords: Anatomic shoulder arthroplasty; Walch B2 glenoid; glenoid retroversion; posterior humeral subluxation; tantalum; trabecular metal wedge