Total shoulder arthroplasty with an anterior-offset humeral head in patients with a B2 glenoid

Aaron M. Chamberlain, Nathan Orvets, Brendan Patterson, Peter Chalmers, Michelle Gosselin, Dane Salazar, Jay D. Keener

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: To address severe posterior subluxation associated with the Walch B2 glenoid deformity, the eccentricity of the prosthetic humeral head can be reversed, allowing the humerus to remain in a relatively posterior position while the prosthetic humeral head remains well-centered on the glenoid. This study describes the short-term outcomes after anatomic total shoulder arthroplasty (TSA) using this technique. Methods: We retrospectively reviewed a consecutive series of patients with a B2 glenoid who underwent TSA with the prosthetic eccentric humeral head rotated anteriorly for excessive posterior subluxation noted intraoperatively. Medical records were reviewed for visual analog scale (VAS), American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), and Simple Shoulder Test (SST) scores. Final radiographs were analyzed for instability, lesser tuberosity osteotomy healing, and glenoid loosening. Results: Twenty patients were included with outcome scores at a mean of 48 months. Mean VAS (P <.0001), ASES (P <.0001), and SST (P <.0001) scores improved significantly. Using the Lazarus classification for glenoid loosening, 5 patients had grade 1 lucency and 2 had grade 2 lucency at a mean of 24 months' follow-up. The remaining 13 patients had no glenoid lucencies. Radiographic decentering was reduced from a mean of 9.9% ± 5.7% preoperatively to 0.5% ± 3.0% postoperatively (P <.001). There were no cases of lesser tuberosity repair failures or revision surgery. Conclusion: TSA in patients with a B2 glenoid with a reversed, anterior-offset humeral head to address residual posterior subluxation resulted in excellent functional outcomes at short-term follow-up with improvement in humeral head centering. Early radiographic follow-up suggests low risks of progressive glenoid lucencies and component loosening.

Original languageEnglish
Pages (from-to)638-643
Number of pages6
JournalJSES International
Volume4
Issue number3
DOIs
StatePublished - Sep 2020

Keywords

  • B2 glenoid
  • Case Series
  • Level IV
  • Shoulder arthroplasty
  • Treatment Study
  • glenohumeral osteoarthritis
  • shoulder subluxation

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