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Is bone grafting always necessary in revision reverse total shoulder arthroplasty with uncontained glenoid bone defects?

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Abstract
BACKGROUND: Patients with an uncontained glenoid bone defect can still successfully undergo a reverse total shoulder arthroplasty (RTSA). Currently there is a tendency towards reconstruction of the premorbid glenoid plane with bone grafts which is technically demanding. We investigated if central peg positioning in the spine pillar (CPPSP) is a more feasible alternative to the use of bone grafts. METHODS: 60 revisions to a RTSA with uncontained glenoid bone defects were included in this study. Patients were treated with bone grafts in 29 cases and with the CPPSP technique in 31 cases. We assessed clinical results using the Constant score and assessed the complication ratio. RESULTS: In the CPPSP group the Constant score changed from 42 to 69 points. In the bone graft group it changed from 47 to 60 points. This difference in increase in Constant score was significant (p=0.031), due to a significant difference in strength, in favor of the CPPSP group. The overall complication rate was 37,7% (20/53) with a reoperation rate of 18,9% (10/53). Dislocations occurred only in the CPPSP group (n=3) and loosening of the glenoid occurred only in the bone graft group (n=3). CONCLUSION: Patients with uncontained glenoid bone defects undergoing a revision to a RTSP obtain similar clinical results with the CPPSP technique compared to the use of bone grafts. The CPPSP technique is a valid alternative but has different complications. LEVEL OF EVIDENCE: Level III; Retrospective Cohort Comparison; Treatment Study.

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MLA
Verstuyft, Lotte, et al. “Is Bone Grafting Always Necessary in Revision Reverse Total Shoulder Arthroplasty with Uncontained Glenoid Bone Defects?” JOURNAL OF SHOULDER AND ELBOW SURGERY, 2021, doi:10.1016/j.jse.2020.10.033.
APA
Verstuyft, L., Vergison, L., Van Tongel, A., & De Wilde, L. (2021). Is bone grafting always necessary in revision reverse total shoulder arthroplasty with uncontained glenoid bone defects? JOURNAL OF SHOULDER AND ELBOW SURGERY. https://doi.org/10.1016/j.jse.2020.10.033
Chicago author-date
Verstuyft, Lotte, Laurence Vergison, Alexander Van Tongel, and Lieven De Wilde. 2021. “Is Bone Grafting Always Necessary in Revision Reverse Total Shoulder Arthroplasty with Uncontained Glenoid Bone Defects?” JOURNAL OF SHOULDER AND ELBOW SURGERY. https://doi.org/10.1016/j.jse.2020.10.033.
Chicago author-date (all authors)
Verstuyft, Lotte, Laurence Vergison, Alexander Van Tongel, and Lieven De Wilde. 2021. “Is Bone Grafting Always Necessary in Revision Reverse Total Shoulder Arthroplasty with Uncontained Glenoid Bone Defects?” JOURNAL OF SHOULDER AND ELBOW SURGERY. doi:10.1016/j.jse.2020.10.033.
Vancouver
1.
Verstuyft L, Vergison L, Van Tongel A, De Wilde L. Is bone grafting always necessary in revision reverse total shoulder arthroplasty with uncontained glenoid bone defects? JOURNAL OF SHOULDER AND ELBOW SURGERY. 2021;
IEEE
[1]
L. Verstuyft, L. Vergison, A. Van Tongel, and L. De Wilde, “Is bone grafting always necessary in revision reverse total shoulder arthroplasty with uncontained glenoid bone defects?,” JOURNAL OF SHOULDER AND ELBOW SURGERY, 2021.
@article{8690812,
  abstract     = {BACKGROUND: Patients with an uncontained glenoid bone defect can still successfully undergo a reverse total shoulder arthroplasty (RTSA). Currently there is a tendency towards reconstruction of the premorbid glenoid plane with bone grafts which is technically demanding. We investigated if central peg positioning in the spine pillar (CPPSP) is a more feasible alternative to the use of bone grafts. METHODS: 60 revisions to a RTSA with uncontained glenoid bone defects were included in this study. Patients were treated with bone grafts in 29 cases and with the CPPSP technique in 31 cases. We assessed clinical results using the Constant score and assessed the complication ratio. RESULTS: In the CPPSP group the Constant score changed from 42 to 69 points. In the bone graft group it changed from 47 to 60 points. This difference in increase in Constant score was significant (p=0.031), due to a significant difference in strength, in favor of the CPPSP group. The overall complication rate was 37,7% (20/53) with a reoperation rate of 18,9% (10/53). Dislocations occurred only in the CPPSP group (n=3) and loosening of the glenoid occurred only in the bone graft group (n=3). CONCLUSION: Patients with uncontained glenoid bone defects undergoing a revision to a RTSP obtain similar clinical results with the CPPSP technique compared to the use of bone grafts. The CPPSP technique is a valid alternative but has different complications. LEVEL OF EVIDENCE: Level III; Retrospective Cohort Comparison; Treatment Study.},
  author       = {Verstuyft, Lotte and Vergison, Laurence and Van Tongel, Alexander and De Wilde, Lieven},
  issn         = {1058-2746},
  journal      = {JOURNAL OF SHOULDER AND ELBOW SURGERY},
  language     = {eng},
  pages        = {8},
  title        = {Is bone grafting always necessary in revision reverse total shoulder arthroplasty with uncontained glenoid bone defects?},
  url          = {http://dx.doi.org/10.1016/j.jse.2020.10.033},
  year         = {2021},
}

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