Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Current Reviews in Musculoskeletal Medicine
Published in: Current Reviews in Musculoskeletal Medicine 1/2016

01-03-2016 | Shoulder Arthroplasty (G Athwal, Section Editor)

Surgical management of the biconcave (B2) glenoid

Authors: Kenneth W. Donohue, Eric T. Ricchetti, Joseph P. Iannotti

Published in: Current Reviews in Musculoskeletal Medicine | Issue 1/2016

Login to get access

Abstract

Glenohumeral osteoarthritis produces a wide spectrum of glenoid pathology. The B2 glenoid is defined by asymmetric posterior bone loss with the development of a biconcavity and posterior translation of the humeral head. Progressive bone loss results in increasing glenoid retroversion, which must be corrected during anatomic shoulder arthroplasty. The goals of arthroplasty should also include centering the humeral head and restoring the normal glenoid joint line. When there is minimal bone loss, this may be accomplished with a standard glenoid component and asymmetric reaming. More significant bone loss requires bone grafting or the use of an augmented glenoid component. Reverse shoulder arthroplasty is also an option for older patients or patients with severe bone loss.
Literature
1.
Walch G, Badet R, Boulahia A, Khoury A. Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplasty. 1999;14(6):756–60.CrossRefPubMed
2.•
Scalise JJ, Codsi MJ, Bryan J, Iannotti JP. The three-dimensional glenoid vault model can estimate normal glenoid version in osteoarthritis. J Should Elb Surg. 2008;17:487–91. Imaging study of 14 patients with unilateral glenohumeral arthritis and bilateral shoulder CT scans. Validated the vault model for estimating version in pathologic and non-pathologic glenoids. CrossRef
3.
Codsi MJ, Bennetts C, Gordiev K, Baeck DM, Kwon Y, Brems J, et al. Normal glenoid vault anatomy and validation of a novel glenoid implant shape. J Should Elb Surg. 2008;17:471–8.CrossRef
4.
Ganapathi A, McCarron JA, Chen X, Iannotti JP. Predicting normal glenoid version from the pathologic scapula: a comparison of 4 methods in 2- and 3-dimensional models. J Should Elb Surg. 2011;20:234–44.CrossRef
5.
Ricchetti ET, Hendel MD, Collins DN, Iannotti JP. Is premorbid glenoid anatomy altered in patients with glenohumeral osteoarthritis? Clin Orthop Relat Res. 2013;471:2932–39.PubMedCentralCrossRefPubMed
6.
Sabesan VJ, Callanan M, Youderian A, Iannotti JP. CT assessment of the relationship of humeral head alignment and glenoid retroversion in glenohumeral arthritis. J Bone Joint Surg Am. 2014;96:e64(1–7).CrossRef
7.
Iannotti JP, Greeson C, Downing D, Sabesan V, Bryan JA. Effect of glenoid deformity on glenoid component placement in primary shoulder arthroplasty. J Should Elb Surg. 2012;21:48–55.CrossRef
8.
Iannotti JP, Norris TR. Influence of preoperative factors on outcome of shoulder arthroplasty for glenohumeral osteoarthritis. J Bone Joint Surg Am. 2003;85:251–8.PubMed
9.
Ho JC, Sabesan VJ, Iannotti JP. Glenoid component retroversion is associated with osteolysis. J Bone Joint Surg Am. 2013;95:e82(1–8).CrossRef
10.
Gerber C, Costouros JG, Sukthankar A, Fucentese SF. Static posterior humeral head subluxation and total shoulder arthroplasty. J Should Elb Surg. 2009;18:505–10.CrossRef
11.
Farron A, Terrier A, Buchler P. Risks of loosening of a prosthetic glenoid implanted in retroversion. J Should Elb Surg. 2006;15:521–6.CrossRef
12.
Strauss EJ, Roche C, Flurin PH, Wright T, Zuckerman JD. The glenoid in shoulder arthroplasty. J Should Elb Surg. 2009;18:819–33.CrossRef
13.
Terrier A, Buchler P, Farron A. Influence of glenohumeral conformity on glenoid stresses after total shoulder arthroplasty. J Should Elb Surg. 2006;15:515–20.CrossRef
14.•
Mizuno N, Denard R, Raiss P, Walch G. Reverse total shoulder arthroplasty for primary glenohumeral osteoarthritis in patients with a biconcave glenoid. J Bone Joint Surg Am. 2013;95:1297–304. A retrospective review reporting excellent clinical results following reverse shoulder arthroplasty in 27 patients with a biconcave glenoid. Average age was 74.1 years at the time of surgery and mean follow up was 54 months. CrossRefPubMed
15.
Bokor DJ, O’Sullivan MD, Hazan GJ. Variability of measurement of glenoid version on computed tomography scan. J Should Elb Surg. 1999;8(6):595–8.CrossRef
16.
Bryce CD, Davison AC, Lewis GS, Wang L, Flemming DJ, Armstrong AD. Two- dimensional glenoid version measurements vary with coronal and sagittal scapular rotation. J Bone Joint Surg Am. 2010;92:692–9.CrossRefPubMed
17.
Green A, Norris TR. Imaging techniques for glenohumeral arthritis and glenohumeral arthroplasty. Clin Orthop Relat Res. 1994;307:7–17.PubMed
18.
Friedman RJ, Hawthorne KB, Genez BM. The use of computerized tomography in the measurement of glenoid version. J Bone Joint Surg Am. 1992;74:1032–7.PubMed
19.
Nyffeler RW, Jost B, Pfirrmann CW, Gerber C. Measurement of glenoid version: conventional radiographs versus computed tomography scans. J Should Elb Surg. 2003;12:493–6.CrossRef
20.
Ogawa K, Yoshida A, Ikegami H. Osteoarthritis in shoulders with traumatic anterior instability: preoperative survey using radiography and computed tomography. J Should Elb Surg. 2006;15:23–9.CrossRef
21.
Welsch G, Mamisch TC, Kikinis R, Schmidt R, Lang P, Forst R, et al. CT-based preoperative analysis of scapula morphology and glenohumeral joint geometry. Comput Aided Surg. 2003;8:264–8.CrossRefPubMed
22.
Couteau B, Mansat P, Mansat M, Darmana R, Egan J. In vivo characterization of glenoid with use of computed tomography. J Should Elb Surg. 2001;10:116–22.CrossRef
23.
Scalise JJ, Codsi MJ, Bryan J, Brems JJ, Iannotti JP. The influence of three-dimensional computed tomography images of the shoulder in preoperative planning for total shoulder arthroplasty. J Bone Joint Surg Am. 2008;90:2438–45.CrossRefPubMed
24.•
Iannotti JP, Weiner S, Rodriguez E, Patterson TE, Jun BJ, Ricchetti ET. Three dimensional imaging and templating improve glenoid implant positioning. J Bone Joint Surg Am. 2015;97:651–8. A randomized clinical trial reporting improvement in glenoid component placement with three dimensional imaging and templating vs. two dimensional imaging. This effect was independent of patient specific instrumentation. CrossRefPubMed
25.
Iannotti J, Baker J, Rodriguez E, Brems J, Ricchetti E, Mesiha M, et al. Three-dimensional preoperative planning software and a novel information transfer technology improve glenoid component positioning. J Bone Joint Surg Am. 2014;96:e71(1–8).CrossRef
26.
Scalise JJ, Bryan J, Polster J, Brems JJ, Iannotti JP. Quantitative analysis of glenoid bone loss in osteoarthritis using three-dimensional computed tomography scans. J Should Elb Surg. 2008;17(2):328–35.CrossRef
27.
Youderian AR, Iannotti JP. Preoperative planning using advanced 3-dimensional virtual imaging software for glenoid component in anatomic total shoulder replacement. Tech Should Elb Surg. 2012;13(4):145–50.CrossRef
28.•
Hendel MD, Bryan JA, Barsoum WK, Rodriguez EJ, Brems JJ, Evans PJ, et al. Comparison of patient-specific instruments with standard surgical instruments in determining glenoid component position: a randomized prospective clinical trial. J Bone Joint Surg Am. 2012;94:2167–75. A prospective randomized clinical trial comparing patient specific instrumentation and three dimensional CT planning to standard instrumentation and two dimensional CT planning. Patient specific instrumentation with three dimensional planning was shown to significantly influence surgeon implant selection when deciding between standard or augmented glenoid components. The greatest benefit of patient specific instrumentation was seen in patients with retroversion in excess of 16°. CrossRefPubMed
29.
Levine WN, Djurasovic M, Glasson JM, Pollock RG, Flatow EL, Bigliani LU. Hemiarthroplasty for glenohumeral osteoarthritis: results correlated to degree of glenoid wear. J Should Elb Surg. 1997;6(5):449–54.CrossRef
30.
Hsu JE, Ricchetti ET, Huffman GR, Iannotti JP, Glaser DL. Addressing glenoid bone deficiency and asymmetric posterior erosion in shoulder arthroplasty. J Should Elb Surg. 2013;22:1298–308.CrossRef
31.
Matsen 3rd FA, Warme WJ, Jackins SE. Can the ream and run procedure improve glenohumeral relationships and function for shoulders with the arthritic triad? Clin Orthop Relat Res. 2015;473(6):2088–96.CrossRefPubMed
32.
Matsen 3rd FA, Lippitt SB. Current technique for the ream-and-run arthroplasty for glenohumeral osteoarthritis. JBJS Essent Surg Technol. 2012;2:e20(21–15).
33.•
Youderian AR, Napolitano Jr LA, Davidson IU, Iannotti JP. Management of glenoid bone loss with the use of a new augmented all-polyethylene glenoid component. Tech Should Elb Surg. 2012;13(4):163–9. Technique article discussing preoperative planning and surgical technique for managing glenoid bone loss with an augmented stepped component (StepTech APG, DePuy; Warsaw, IN). CrossRef
34.
Nowak DD, Bahu MJ, Gardner TR, et al. Simulation of surgical glenoid resurfacing using three-dimensional computed tomography of the arthritic glenohumeral joint: the amount of glenoid retroversion that can be corrected. J Should Elb Surg. 2009;18:680–8.CrossRef
35.
Gillespie R, Lyons R, Lazarus M. Eccentric reaming in total shoulder arthroplasty: a cadaveric study. Orthopedics. 2009;32:1.CrossRef
36.
Walch G, Young AA, Boileau P, Loew M, Gazielly D, Mole D. Patterns of loosening of polyethylene keeled glenoid components after shoulder arthroplasty for primary osteoarthritis: results of a multi-center study with more than 5 years of follow-up. J Bone Joint Surg Am. 2012;94:145–50.CrossRefPubMed
37.•
Sabesan V, Callanan M, Sharma V, Iannotti JP. Correction of acquired glenoid bone loss in osteoarthritis with a standard vs. an augmented glenoid component. J Should Elb Surg. 2014;23(7):964–73. A three dimensional computer simulation study comparing the use of standard and augmented glenoid components in 29 patients with glenohumeral arthritis and acquired posterior glenoid bone loss. Illustrates the amount of joint line medialization required to correct glenoid version with each type of component. CrossRef
38.
Neer II CS, Morrison DS. Glenoid bone-grafting in total shoulder arthroplasty. J Bone Joint Surg Am. 1988;70A:1154–62.
39.
Steinmann SP, Cofield RH. Bone grafting for glenoid deficiency in total shoulder replacement. J Should Elb Surg. 2000;9:361–7.CrossRef
40.•
Sabesan V, Callanan M, Ho J, Iannotti JP. Clinical and radiographic outcomes of total shoulder arthroplasty with bone graft for osteoarthritis with severe glenoid bone loss. J Bone Joint Surg Am. 2013;95:1290–6. Retrospective review reporting good clinical and radiographic results with the use of bone graft and a standard glenoid component in 12 shoulders (9 biconcave glenoids) with glenohumeral arthritis at average 53 month follow-up. CrossRefPubMed
41.•
Klika BJ, Wooten CW, Sperling JW, Steinmann SP, Schleck CD, Harmsen WS, et al. Structural bone grafting for glenoid deficiency in primary total shoulder arthroplasty. J Should Elb Surg. 2014;23:1066–72. Retrospective review reporting favorable clinical outcome despite unfavorable radiographic results with the use of bone graft and a standard glenoid component in 25 shoulders with glenohumeral arthritis at average 8.7 years follow-up. CrossRef
42.
Tammachote N, Sperling JW, Vathana T, Cofield RH, Harmsen WS, Schleck CD. Long term results of cemented metal-backed components in osteoarthritis. J Bone Joint Surg Am. 2009;9:160–6.CrossRef
43.
Cil A, Sperling J, Cofield R. Nonstandard glenoid components for bone deficiencies in shoulder arthroplasty. J Should Elb Surg. 2014;23:e149–57.CrossRef
44.
Iannotti JP, Lappin KE, Klotz CL, Reber EW, Swope SW. Liftoff resistance of augmented glenoid components during cyclic fatigue loading in the posterior-superior direction. J Should Elb Surg. 2013;22:1530–6.CrossRef
45.
Walch G, Moraga C, Young A, Castellanos-Rosas J. Results of anatomic non-constrained prosthesis in primary osteoarthritis with biconcave glenoid. J Should Elb Surg. 2012;21:1526–33.CrossRef
Metadata
Title
Surgical management of the biconcave (B2) glenoid
Authors
Kenneth W. Donohue
Eric T. Ricchetti
Joseph P. Iannotti
Publication date
01-03-2016
Publisher
Springer US
Published in
Current Reviews in Musculoskeletal Medicine / Issue 1/2016
Electronic ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-016-9315-1

Other articles of this Issue 1/2016

Current Reviews in Musculoskeletal Medicine 1/2016 Go to the issue

Hip: Metal-on-Metal (J Cooper, Section Editor)

Diagnosis of adverse local tissue reactions following metal-on-metal hip arthroplasty

Shoulder Arthroplasty (G Athwal, Section Editor)

Planning software and patient-specific instruments in shoulder arthroplasty

Hip: Metal-on-Metal (J Cooper, Section Editor)

Revision for taper corrosion at the head-neck junction: pearls and pitfalls

Shoulder Arthroplasty (G Athwal, Section Editor)

Porous metals and alternate bearing surfaces in shoulder arthroplasty

Shoulder Arthroplasty (G Athwal, Section Editor)

Safety and efficacy of arthroscopy in the setting of shoulder arthroplasty

Hip: Metal-on-Metal (J Cooper, Section Editor)

Revision for taper corrosion at the neck-body junction following total hip arthroplasty: pearls and pitfalls