SURGICAL PEARLS: Dealing with Bone Loss in Shoulder Arthroplasty

    Bone loss is uncommon in primary shoulder arthroplasty, Evan S. Lederman, MD, told attendees at last year’s 8th Annual Shoulder Course, and is usually seen as a sequela of a shoulder fracture. In his presentation, Dr. Lederman reviewed the management of proximal humerus bone deficiency and glenoid defects.

    Dr. Lederman, from The University of Arizona College of Medicine – Phoenix, noted that deficient proximal humerus bone can cause issues such as insufficient deltoid tension and lack of native bone to support an implant’s humeral component. He rarely performs anatomic shoulder arthroplasty in these patients, opting instead for reverse shoulder arthroplasty, often with allograft or metal support. In some cases, tendon transfer may be needed.

    With primary glenoid deficiency, the goals are to restore the joint line, save the bone, and support the implant. Management options for these patients include corrective reaming, bone graft, augmented implant, convertible glenoid, and reverse shoulder arthroplasty.

    Click the image above to watch Dr. Lederman’s presentation.

    There’s still time to register for the final session in the virtual CME series, ICJR Insights: Advanced Concepts® in Shoulder Surgery, on November 4 and learn more about anatomic and reverse shoulder arthroplasty. Click here to register.