Name: Addressing the Complex Glenoid
Uploaded: 2016-03-10T00:00:00Z
Channel: Arthrex

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VPT1-00596-EN | B | Addressing the Complex Glenoid

Brad Parsons

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Addressing the Complex Glenoid

One of the challenges we face in shoulder replacement surgery is how to handle the biconcave, or severely worn glenoid. We're currently learning a lot about what is a biconcave glenoid. What is an eroded glenoid? What's a B2, B3? These are words you might hear as we discuss these topics. One of the things that Arthrex provides me the ability to do with some of its instrumentation and prosthetic design, is handle the Biconcave glenoid in a variety of ways. For the young, more active patient with mild to moderate posterior wear of the glenoid, I'd consider that somewhere between 5 and 10 degrees of concavity. I'll consider an asymmetric reaming. I'll use the Nautilus system to help me guide my reaming, so that I have a very controlled and measured way of reaming, so I'm not getting too deep into the subchondral bone. I can use the Nautilus offset or angled guides to help me establish that center pin and build everything from there. More severe cases, especially in older folks. I'll consider doing a reverse replacement. Our European colleagues have led the way in telling us that the reverse may be the most predictable thing for some of these severely biconcave glenoid patients, and certainly in the older patients, I think the idea of being able to use a 135 implant to maintain good function, good cuff tension of the residual cuff that's there. Good deltoid tone might give us an even better longevity than what we're seeing with some of the classic Grammont style implants.

Addressing the Complex Glenoid

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