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Anatomic Shoulder Arthroplasty: Technical Considerations

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Keywords: Glenohumeral arthritis, Glenoid bone loss, Lesser tuberosity osteotomy, Midsubstance tenotomy, Reverse total shoulder arthroplasty, Subscapularis peel, Subscapularis-preserving, Total shoulder arthroplasty, Type B2 glenoid. Graphic depicting the Friedman red , scapula body yellow and intermediate blue line methods of determining scapular version.

Validity of different methods in two-dimensional computed tomography scans. J Shoulder Elbow Surg ;19 [ 8 ] Image depicting a type B2 glenoid A With three reference lines described by Walch: B The paleoglenoid, which represents the native glenoid version, C Intermediate glenoid, and D The neoglenoid, representing the new version of the glenoid. Approaches 3. Deltopectoral Approach The standard approach for surgical exposure during shoulder arthroplasty is the deltopectoral approach [ 22 , 23 ]. Subscapularis-Preserving Approach This approach begins with a vertical incision beginning just anterior to the posterior margin of the acromioclavicular joint, followed by a superficial dissection down to deltoid fascia, with full-thickness skin flaps developed on both sides of the incision to allow for access to the anterior, and posterior borders of the acromion [ 43 ].

Anteromedial Approach The anteromedial approach to the shoulder dates back to the early 20 th century [ 45 ], but it was only later described in the context of shoulder arthroplasty by Neer et al.

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Illustration depicting steps in glenoid bone grafting. A Glenoid with significant posterior erosion.

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B Preparation of the anterior glenoid. C Bone graft placement in deficient area, temporarily held in place with drills. D Replacement of the drills with 3. Bone grafting for glenoid deficiency in total shoulder replacement. Total shoulder arthroplasty with the Neer prosthesis. J Bone Joint Surg Am ; 66 6 : CrossRef PubMed. Processing Time: Average publication time of 18 days between final acceptance of revised manuscript and its publication. View Editorial Board. Articles Abstracts Issues. Join Our Editorial Board News release date: March 29, Description: The Open Orthopaedics Journal is an Open Access online journal, which publishes research articles, reviews, letters, case reports and guest-edited single topic issues in all areas of experimental and clinical research and surgery in orthopaedics.

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UCB S. Westat, USA. University of Oxford, UK. Almac Sciences, Northern Ireland. Delft University of Technology, The Netherlands. Sapienza - University of Rome, Italy. Paris University, France. Instituto de Agroquimica y Tecnologia de Alimentos, Spain.


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University Clinic of Navarre, Spain. University of Vienna, Austria. Chiba University, Japan. National Central University, Taiwan. Cofield RH. Functional outcome after shoulder arthroplasty for primary osteoarthritis: A multicenter study. Increasing incidence of shoulder arthroplasty in the United States.

J Bone Joint Surg Am ; 93 24 : Prevention of complications in shoulder arthroplasty: understanding options and critical steps. Instr Course Lect ; Shoulder arthroplasty: Evolving techniques and indications.. Joint, bone, spine : Revue du rhumatisme ; 77 6 : Glenoid bone loss in primary total shoulder arthroplasty: evaluation and management. J Am Acad Orthop Surg ; 20 9 : Survivorship of the humeral component in shoulder arthroplasty.

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J shoulder elbow surg Am Shoulder Elbow Surg ; 19 1 : Complications of total shoulder arthroplasty. J Bone Joint Surg Am ; 88 10 : Surgical approach and techniques for total shoulder arthroplasty: Tips and tricks. Measurement of glenoid version: conventional radiographs versus computed tomography scans. J shoulder elbow surg Am Shoulder Elbow Surg ; 12 5 : Glenoid version: how to measure it? J shoulder elbow surg Am Shoulder Elbow Surg ; 19 8 : Randelli M, Gambrioli PL. Glenohumeral osteometry by computed tomography in normal and unstable shoulders.

Clin Orthop Relat Res ; : Neer CS II. Replacement arthroplasty for glenohumeral osteoarthritis. J Bone Joint Surg Am ; 56 1 : Influence of preoperative factors on outcome of shoulder arthroplasty for glenohumeral osteoarthritis. J bone jt surg Am Vol ; 85 2 : Static posterior subluxation of the humeral head: an unrecognized entity responsible for glenohumeral osteoarthritis in the young adult.

J shoulder elbow surg Am Shoulder Elbow Surg ; 11 4 : Edge displacement and deformation of glenoid components in response to eccentric loading. The effect of preparation of the glenoid bone. J Bone Joint Surg Am ; 74 4 : Static posterior humeral head subluxation and total shoulder arthroplasty.