Bone grafting for glenoid deficiency in total shoulder replacement

Twenty-eight patients had glenoid bone grafting for segmental glenoid wear as a part of total shoulder arthroplasty. Nineteen of these patients had os teoarthritis and 5 had arthritis associated with shoulder instability Follo w-up evaluation averaged 5.3 years (range, 2 to I I years). Autogenous hume ral head grafts were used in 27 patients. In 25 patients, 3.5-mm cortical s crews were used for fixation. Postoperatively, there was no or slight pain in 25 patients and moderate pain in 3 patients. Postoperative motion averag ed 126 degrees in abduction, 39 degrees in external rotation, and T12 in in ternal rotation. According to Neer's result rating, 13 shoulders were excel lent, 10 satisfactory, and 5 unsatisfactory (symptomatic glenoid loosening in 2 reoperation for instability in 2 and persistent pain in I). Radiograph ically, 13 shoulders had no lucencies, I I had incomplete lucencies, and 4 had complete lucencies. In 3 of these, the lucencies were at least 1.5 mm w ide. These glenoids were considered radiographically loose; however, only 2 were symptomatic. When this technique is used to restore glenoid bone and joint alignment, clinical and radiographic results are similar to those for total shoulder arthroplasty overall.