Step-Cut Bone-Graft Technique for Osteoarthritis with Severe Glenoid Bone Loss
Year: 2014
Type: article
Abstract: INTRODUCTION: We describe a bone-graft technique, for shoulder arthroplasty in patients with severe glenoid bone loss, that utilizes a "step cut," a trapezoidal bone wedge from the resected humeral head, and graft fixation with screws placed from posterior to anterior through the graft. STEP 1 PREOPERATIVE PLANNING: Carry out preoperative planning for the step-cut procedure. STEP 2 SURGICAL APPROACH AND PREPARATION OF THE GLENOID: Expose the glenoid for bone graft insertion, taking care to avoid excessive reaming. STEP 3 PREPARE THE GLENOID BONE GRAFT: Cut the appropriately sized glenoid bone graft from the resected humeral head. STEP 4 INSERT AND FIX THE GLENOID BONE GRAFT: Position the bone graft in the glenoid defect and stabilize it with screws. STEP 5 PREPARE THE GLENOID SURFACE: Create an even concave surface between the anterior aspect of the glenoid and the posterior aspect of the graft. STEP 6 PLACE THE GLENOID IMPLANT: Position the glenoid component following step-cut graft implantation. POSTOPERATIVE REHABILITATION: Postoperative rehabilitation is mostly the same as that for standard total shoulder replacement without bone-grafting. RESULTS: The range of motion improved significantly in our study of twelve patients (p < 0.001).IndicationsContraindicationsPitfalls & Challenges.
Institutions: Western Michigan University, Harvard University, Cleveland Clinic
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2012978445