Shoulder Arthroplasty: The Glenoid - Ian McDermott 4/10/2001

General points

Neer introduced a nonconstrained total shoulder prosthesis in 1982.

Approximately 90% pain relief " same in RA and OA

Better functional outcome with OA cf RA

ROM at the glenohumeral joint may only be increased slightly, but overall, with good painrelief, total ROM is satisfactory due to unaffected scapulothoracic movement

Rheumatoid Arthritis

3 types:

Dry

Very stiff due to severe fibrosis of soft tissues

Bone quality tends to be good

Wet

Excessive synovial fluid

Soft tissue destruction

Rotator cuff deficiency

Proximal migration of humeral head

Resorptive

Severe bone loss

Medialisation of the humeral head

Rotator cuff failure has been reported in as many as 50% of patients with RA of the shoulder.

Proximal migration of humeral component

eccentric loading on the glenoid

rocking horse phenomenon

loosening of glenoid component

Other papers of interest:-

Stress analyses of glenoid components in total shoulder arthroplasty

Stress analyses of glenoid components in total shoulder arthroplasty

Stone KD. J Shoulder Elbow Surg 1999; 8(2); 151-158

Cemented all-poly glenoid vs uncemented metal-backed component:



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