GLENOID BONE GRAFTING IN REVERSE SHOULDER ARTHROPLASTY: LITERATURE REVIEW, SURGICAL TECHNIQUE AND EARLY RESULTS

Positioning of the glenoid component is one of the keys to successful shoulder arthroplasty. Severe glenoid deformity may compromise baseplate support during reverse shoulder arthroplasty and force excessive medialization if correction is attempted by reaming alone. This paper summarizes the rationale for glenoid bone grafting, presents a structured operative technique and reports early institutional experience. A narrative review of key publications on glenoid bone loss, bony increased-offset reverse shoulder arthroplasty, metallic augments and scapular notching was combined with a descriptive analysis of 5 operated patients. Based on the literature and clinical experience, indications for bone grafting are formulated, the key stages of preoperative planning and a step-by-step surgical technique are described. In the presented series, the mean age was 69.6 years; patient-specific instrumentation was used in 3 cases. Mean operative time was 142 minutes and follow-up ranged from 6 to 18 months.

Graft remodeling and good functional results according to the Constant-Murley score were observed in all cases. Conclusion. Glenoid bone grafting in in reverse shoulder arthroplasty is not a routine substitute for eccentric reaming or metallic augmentation. It is most useful when bone stock restoration and biological lateralization are required, provided that stable fixation and graft-host bone contact can be achieved.

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