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

doi:10.1016/j.jseint.2020.02.001

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

Journal article

Open access

Peer reviewed

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 and Jay D. Keener

JSES international, Vol.4(3), pp.638-643

09/2020

DOI: 10.1016/j.jseint.2020.02.001

PMCID: PMC7478997

PMID: 32939499

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Abstract

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. 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. 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. 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.

B2 glenoid

glenohumeral osteoarthritis

Shoulder arthroplasty

shoulder subluxation

Details

Title: Subtitle: Total shoulder arthroplasty with an anterior-offset humeral head in patients with a B2 glenoid
Creators: Aaron M. Chamberlain - Washington University in St. Louis
Nathan Orvets - Colorado Permanente Medical Group
Brendan Patterson - University of Iowa
Peter Chalmers - University of Utah
Michelle Gosselin - Washington University in St. Louis
Dane Salazar - Loyola University Chicago
Jay D. Keener - Washington University in St. Louis
Resource Type: Journal article
Publication Details: JSES international, Vol.4(3), pp.638-643
DOI: 10.1016/j.jseint.2020.02.001
PMID: 32939499
PMCID: PMC7478997
NLM abbreviation: JSES Int
ISSN: 2666-6383
eISSN: 2666-6383
Publisher: Elsevier Inc
Grant note: DOI: 10.13039/100012630, name: Zimmer Biomet, Inc.; DOI: 10.13039/100012630, name: Zimmer, Inc.; DOI: 10.13039/100000002, name: National Institute of Health
Language: English
Date published: 09/2020
Academic Unit: Orthopedics and Rehabilitation
Record Identifier: 9984304686102771

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