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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