Schulter > Schultergelenkpfanne / Glenoid

Arthropedia – Grundlagenwissen und Fallbeispiele

« zurück

24.09.2021 | Arthropedia | Online-Artikel

Patientenindividuelle glenoidale Implantate in der Schulterendoprothetik

Custom-made glenoid implants in shoulder arthroplasty

Einloggen, um Zugang zu erhalten

Die Behandlung ausgeprägter glenoidaler Knochendefekte ist herausfordernd. Patientenindividuelle glenoidale Implantate stellen diesbezüglich ein neues Verfahren dar, welches mit enormen potenziellen Vorteilen behaftet ist. Die eigenen Erfahrungen zeigen, dass mit dieser Technologie einerseits der glenoidale Knochendefekt reproduzierbar wiederherzustellen ist und andererseits eine stabile Verankerung und eine hochpräzise Implantatpositionierung entsprechend der präoperativen Planung erzielt werden kann. Dies stellt sich besonders im Vergleich zu Alternativverfahren, wie der knöchernen Glenoidaugmentation, als substanzieller Vorteil der Technik für diese häufig hochdefizitären und anspruchsvollen Situationen dar. Nach Durchführung einer Computertomographie (CT) der Schulter wird präoperativ das individuelle Implantatdesign dreidimensional detailliert computergestützt geplant. Von zentraler Bedeutung für die korrekte und planungsgetreue Positionierung des definitiven Implantats während der Operation ist eine präzise Einbringung eines Kirschner-Drahts mittels PSI(„patient specific instrumentation“)-Guide.. Nach Fixation der glenoidalen Komponente kann diese mit Standardimplantaten des jeweiligen Systems kombiniert werden. Die aktuell vorhandene Literatur ist ermutigend und zeigt, dass kurzfristig signifikante klinische Erfolge mit dem Verfahren erzielbar sind. Weitere Forschung im Sinne von biomechanischen Untersuchungen und längeren Nachuntersuchungszeiträumen ist wünschenswert, um die Wertigkeit des Verfahrens weiter zu präzisieren.

Literatur
  1. Antuna SA, Sperling JW, Cofield RH, Rowland CM (2001) Glenoid revision surgery after total shoulder arthroplasty. J Shoulder Elbow Surg 10(3):217–224. 
    https://doi.org/10.1067/mse.2001.113961
  2. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) (2019) Hip, knee & shoulder arthroplasty: 2019 annual report. AOA, Adelaide, S 266–331
  3. Bercik MJ, Kruse K, Yalizis M, Gauci MO, Chaoui J, Walch G (2016) A modification to the Walch classification of the glenoid in primary glenohumeral osteoarthritis using three-dimensional imaging. J Shoulder Elbow Surg 25(10):1601–1606. 
    https://doi.org/10.1016/j.jse.2016.03.010
  4. Bodendorfer BM, Loughran GJ, Looney AM, Velott AT, Stein JA, Lutton DM et al (2020) Short-term outcomes of reverse shoulder arthroplasty using a custom baseplate for severe glenoid deficiency. J Shoulder Elbow Surg. 
    https://doi.org/10.1016/j.jse.2020.08.002
  5. Boileau P, Gauci MO, Wagner ER, Clowez G, Chaoui J, Chelli M et al (2019) The reverse shoulder arthroplasty angle: a new measurement of glenoid inclination for reverse shoulder arthroplasty. J Shoulder Elbow Surg 28(7):1281–1290. 
    https://doi.org/10.1016/j.jse.2018.11.074
  6. Chammaa R, Uri O, Lambert S (2017) Primary shoulder arthroplasty using a custom-made hip-inspired implant for the treatment of advanced glenohumeral arthritis in the presence of severe glenoid bone loss. J Shoulder Elbow Surg 26(1):101–107. 
    https://doi.org/10.1016/j.jse.2016.05.027
  7. Cofield RH (2007) Bone grafting for glenoid bone deficiencies in shoulder arthritis: a review. J Shoulder Elbow Surg 16(5):S273–81. 
    https://doi.org/10.1016/j.jse.2007.03.005
  8. Debeer P, Berghs B, Pouliart N, Van den Bogaert G, Verhaegen F, Nijs S (2019) Treatment of severe glenoid deficiencies in reverse shoulder arthroplasty: the glenius glenoid reconstruction system experience. J Shoulder Elbow Surg 28(8):1601–1608. 
    https://doi.org/10.1016/j.jse.2018.11.061
  9. Dines DM, Gulotta L, Craig EV, Dines JS (2017) Novel solution for massive glenoid defects in shoulder arthroplasty: a patient-specific glenoid vault reconstruction system. Am J Orthop (Belle Mead NJ) 46(2):104–108
  10. Falaise V, Levigne C, Favard L (2011) Scapular notching in reverse shoulder arthroplasties: the influence of glenometaphyseal angle. Orthop Traumatol Surg Res 97(6):S131–7. 
    https://doi.org/10.1016/j.otsr.2011.06.007
  11. Favre P, Sussmann PS, Gerber C (2010) The effect of component positioning on intrinsic stability of the reverse shoulder arthroplasty. J Shoulder Elbow Surg 19(4):550–556. 
    https://doi.org/10.1016/j.jse.2009.11.044
  12. Frankle MA, Teramoto A, Luo Z‑P, Levy JC, Pupello D (2009) Glenoid morphology in reverse shoulder arthroplasty: classification and surgical implications. J Shoulder Elbow Surg 18(6):874–885. 
    Frankle MA, Teramoto A, Luo Z‑P, Levy JC, Pupello D (2009) Glenoid morphology in reverse shoulder arthroplasty: classification and surgical implications. J Shoulder Elbow Surg 18(6):874–885. 
    https://doi.org/10.1016/j.jse.2009.02.013
  13. Gates S, Cutler H, Khazzam M (2019) Outcomes of posterior glenoid bone-grafting in anatomical total shoulder arthroplasty: a systematic review. JBJS Rev 7(9):e6. 
    https://doi.org/10.2106/JBJS.RVW.19.00005
  14. Gohlke F, Werner B (2017) Humeral and glenoid bone loss in shoulder arthroplasty: classification and treatment principles. Orthopade 46(12):1008–1014. 
    https://doi.org/10.1007/s00132-017-3484-5
  15. Gohlke F, Werner B, Wiese I (2019) Glenoid reconstruction in revision shoulder arthroplasty. Oper Orthop Traumatol 31(2):98–114. 
    https://doi.org/10.1007/s00064-019-0594-8
  16. Ghoraishian M, Abboud JA, Romeo AA, Williams GR, Namdari S (2019) Augmented glenoid implants in anatomic total shoulder arthroplasty: review of available implants and current literature. J Shoulder Elbow Surg 28(2):387–395. 
    https://doi.org/10.1016/j.jse.2018.08.017
  17. Guery J, Favard L, Sirveaux F, Oudet D, Mole D, Walch G (2006) Reverse total shoulder arthroplasty. Survivorship analysis of eighty replacements followed for five to ten years. J Bone Joint Surg Am 88(8):1742–1747. 
    https://doi.org/10.2106/JBJS.E.00851
  18. Gunther SB, Lynch TL (2012) Total shoulder replacement surgery with custom glenoid implants for severe bone deficiency. J Shoulder Elbow Surg 21(5):675–684. 
    https://doi.org/10.1016/j.jse.2011.03.023
  19. Gupta A, Thussbas C, Koch M, Seebauer L (2018) Management of glenoid bone defects with reverse shoulder arthroplasty-surgical technique and clinical outcomes. J Shoulder Elbow Surg 27(5):853–862. 
    https://doi.org/10.1016/j.jse.2017.10.004
  20. Hill JM, Norris TR (2001) Long-term results of total shoulder arthroplasty following bone-grafting of the glenoid. J Bone Joint Surg Am 83(6):877–883
  21. Ho JC, Thakar O, Chan WW, Nicholson T, Williams GR, Namdari S (2019) Early radiographic failure of reverse total shoulder arthroplasty with structural bone graft for glenoid bone loss. J Shoulder Elbow Surg. 
    https://doi.org/10.1016/j.jse.2019.07.035
  22. Hsu JE, Ricchetti ET, Huffman GR, Iannotti JP, Glaser DL (2013) Addressing glenoid bone deficiency and asymmetric posterior erosion in shoulder arthroplasty. J Shoulder Elbow Surg 22(9):1298–1308. 
    https://doi.org/10.1016/j.jse.2013.04.014
  23. Laver L, Garrigues GE (2014) Avoiding superior tilt in reverse shoulder arthroplasty: a review of the literature and technical recommendations. J Shoulder Elbow Surg 23(10):1582–1590. 
    https://doi.org/10.1016/j.jse.2014.06.029
  24. Levine WN, Djurasovic M, Glasson JM, Pollock RG, Flatow EL, Bigliani LU (1997) Hemiarthroplasty for glenohumeral osteoarthritis: results correlated to degree of glenoid wear. J Shoulder Elbow Surg 6(5):449–454. 
    https://doi.org/10.1016/s1058-2746(97)70052-1
  25. Michael RJ, Schoch BS, King JJ, Wright TW (2018) Managing glenoid bone deficiency-the augment experience in anatomic and reverse shoulder arthroplasty. Am J Orthop. 
    https://doi.org/10.12788/ajo.2018.0014
  26. National joint registry for England, Wales, Northern Ireland and the Isle of Man (NJR EWNIIM) (2018) 15th annual report 2018, S 159
  27. Neyton L, Kirsch JM, Collotte P, Collin P, Gossing L, Chelli M et al (2019) Mid- to long-term follow-up of shoulder arthroplasty for primary glenohumeral osteoarthritis in patients aged 60 or under. J Shoulder Elbow Surg 28(9):1666–1673. 
    https://doi.org/10.1016/j.jse.2019.03.006
  28. Nyffeler RW, Werner CM, Gerber C (2005) Biomechanical relevance of glenoid component positioning in the reverse delta III total shoulder prosthesis. J Shoulder Elbow Surg 14(5):524–528. 
    https://doi.org/10.1016/j.jse.2004.09.010
  29. Oppermann J, Celik E, Bredow J, Beyer F, Hackl M, Spies CK et al (2016) Shoulder arthroplasty in Germany: 2005–2012. Arch Orthop Trauma Surg 136(5):723–729. 
    https://doi.org/10.1007/s00402-016-2417-9
  30. Porcellini G, Micheloni GM, Tarallo L, Paladini P, Merolla G, Catani F (2021) Custom-made reverse shoulder arthroplasty for severe glenoid bone loss: review of the literature and our preliminary results. J Orthop Traumatol 22(1):2. 
    https://doi.org/10.1186/s10195-020-00564-6
  31. Rangarajan R, Blout CK, Patel VV, Bastian SA, Lee BK, Itamura JM (2020) Early results of reverse total shoulder arthroplasty using a patient-matched glenoid implant for severe glenoid bone deficiency. J Shoulder Elbow Surg 29(7S):S139–S148. 
    https://doi.org/10.1016/j.jse.2020.04.024
  32. Rasmussen JV, Harjula J, Arverud ED, Hole R, Jensen SL, Brorson S et al (2019) The short-term survival of total stemless shoulder arthroplasty for osteoarthritis is comparable to that of total stemmed shoulder arthroplasty: a nordic arthroplasty register association study. J Shoulder Elbow Surg 28(8):1578–1586. 
    https://doi.org/10.1016/j.jse.2019.01.010
  33. Sandow MJ, David H, Bentall SJ (2013) Hemiarthroplasty vs total shoulder replacement for rotator cuff intact osteoarthritis: how do they fare after a decade? J Shoulder Elbow Surg 22(7):877–885. 
    https://doi.org/10.1016/j.jse.2012.10.023
  34. Scalise JJ, Iannotti JP (2008) Bone grafting severe glenoid defects in revision shoulder arthroplasty. Clin Orthop Relat Res 466(1):139–145. 
    https://doi.org/10.1007/s11999-007-0065-563
  35. Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Molé D (2004) Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Joint Surg Br 86(3):388–395. 
    https://doi.org/10.1302/0301-620x.86b3.14024
  36. Steinmann SP, Cofield RH (2000) Bone grafting for glenoid deficiency in total shoulder replacement. J Shoulder Elbow Surg 9(5):361–367. 
    https://doi.org/10.1067/mse.2000.106921
  37. Stephens SP, Paisley KC, Jeng J, Dutta AK, Wirth MA (2015) Shoulder arthroplasty in the presence of posterior glenoid bone loss. J Bone Joint Surg Am 97(3):251–259. 
    https://doi.org/10.2106/JBJS.N.00566
  38. Stoffelen DVC, Eraly K, Debeer P (2015) The use of 3D printing technology in reconstruction of a severe glenoid defect: a case report with 2.5 years of follow-up. J Shoulder Elbow Surg 24(8):e218–222. 
    https://doi.org/10.1016/j.jse.2015.04.006
  39. Valenti P, Sauzières P, Katz D, Kalouche I, Kilinc AS (2011) Do less medialized reverse shoulder prostheses increase motion and reduce notching? Clin Orthop Relat Res 469(9):2550–2557. 
    https://doi.org/10.1007/s11999-011-1844-8
  40. Walch G, Badet R, Boulahia A, Khoury A (1999) Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplasty 14(6):756–760. 
    https://doi.org/10.1016/s0883-5403(99)90232-2
  41. Walch G, Moraga C, Young A, Castellanos-Rosas J (2012) Results of anatomic nonconstrained prosthesis in primary osteoarthritis with biconcave glenoid. J Shoulder Elbow Surg 21(11):1526–1533. 
    https://doi.org/10.1016/j.jse.2011.11.030
  42. Westermann RW, Pugely AJ, Martin CT, Gao Y, Wolf BR, Hettrich CM (2015) Reverse shoulder arthroplasty in the United States: a comparison of national volume, patient demographics, complications, and surgical indications. Iowa Orthop J 35:1–7
  43. Williams GR, Iannotti JP (2007) Options for glenoid bone loss: composites of prosthetics and biologics. J Shoulder Elbow Surg 16(5):S267–72. 
    https://doi.org/10.1016/j.jse.2007.05.003
  44. Gauci MO, Cavalier M, Gonzalez JF, Holzer N, Baring T, Walch G et al (2020) Revision of failed shoulder arthroplasty: epidemiology, etiology, and surgical options. Journal of Shoulder and Elbow Surgery 29(3):541–549
  45. Young A, Walch G, Boileau P, Favard L, Gohlke F, Loew M et al (2011) A multicentre study of the long-term results of using a flat-back polyethylene glenoid component in shoulder replacement for primary osteoarthritis. The Journal of Bone and Joint Surgery. British volume 93-B(2):210–216
  46. Fevang BT, Lie SA, Havelin LI, Skredderstuen A, Furnes O (2009) Risk factors for revision after shoulder arthroplasty. Acta Orthopaedica 80(1):83–91
  47. Denard PJ, Lederman E, Parsons BO, Romeo AA (2017) Finite element analysis of glenoid-sided lateralization in reverse shoulder arthroplasty. Journal of Orthopaedic Research 35(7):1548-1555