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Reimplantation of a Glenoid Component Following Component Removal and Allogenic Bone-Grafting

¹ Department of Orthopaedic Surgery, Stanford University, 300 Pasteur Drive, Edwards R155, Stanford, CA 94305
² Mayo Clinic, 200 First Street S.W., Rochester, MN 55905

Investigation performed at the Mayo Clinic, Rochester, Minnesota

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. A commercial entity (Smith and Nephew) paid or directed in any one year, or agreed to pay or direct, benefits in excess of $10,000 to a research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Methods: We reviewed the data on seven shoulders in seven patients. At the time of glenoid component reimplantation, two shoulders received a cemented all-polyethylene glenoid component, three received a bone-ingrowth metal-backed component with columns and screws, and two received a bone-ingrowth metal-backed component with columns and screws augmented with bone cement. The average duration of follow-up was seventy-nine months. At the time of the latest follow-up, all patients were evaluated clinically and radiographically, patient satisfaction was assessed, and the result was graded according to a modified Neer rating system.

Results: Two patients had positive growth of Propionibacterium acnes on culture of intraoperative specimens obtained at the time of revision surgery and had continuing pain, and both underwent repeat revision. The remaining five patients expressed satisfaction with the procedure and stated that they felt better following surgery. The mean preoperative pain score for these five patients (on a scale from 1 to 5) was 4.6, and the mean postoperative pain score was 2.4 (p = 0.0042). Range of motion, however, did not improve. The Neer rating of the result (determined for the five patients who did not undergo repeat revision) was excellent for one patient, satisfactory for one, and unsatisfactory (because of limitation of motion) for three.

Conclusions: Reimplantation of a glenoid component into a previously grafted bed can provide pain relief for most patients, but motion cannot be reliably improved.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

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