Step-Cut Bone-Graft Technique for Osteoarthritis with Severe Glenoid Bone Loss.

Sabesan, Vani; Sharma, Vinay; Callanan, Mark; Ho, Jason; Iannotti, Joseph · JBJS Essent Surg Tech · 2014

case_series · Level IV

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Abstract

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. Carry out preoperative planning for the step-cut procedure. Expose the glenoid for bone graft insertion, taking care to avoid excessive reaming. Cut the appropriately sized glenoid bone graft from the resected humeral head. Position the bone graft in the glenoid defect and stabilize it with screws. Create an even concave surface between the anterior aspect of the glenoid and the posterior aspect of the graft. Position the glenoid component following step-cut graft implantation. Postoperative rehabilitation is mostly the same as that for standard total shoulder replacement without bone-grafting. The range of motion improved significantly in our study of twelve patients (p < 0.001).IndicationsContraindicationsPitfalls & Challenges.