Massive Allograft for Shoulder Arthroplasty: A Case Report

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Abstract

Severe glenoid retroversion and posterior glenoid wear associated with glenohumeral osteoarthritis remain difficult problems to manage. When posterior glenoid bone loss exceeds the capabilities of eccentric reaming, structural bone grafts offer the ability to improve version, reestablish the joint line, and restore glenoid bone deficiency with the potential for biological incorporation. Options to address in patients below 50 years old are the use of an asymmetric glenoid component, a bone grafting in the posterior surface of the glenoid, or a massive allograft (glenoid, tibial plateau, distal tibia). We present the case of a 46-year-old man who was referred for the evaluation of longstanding left-shoulder pain in obstetrical plexus palsy. A distal cryopreserved tibia allograft was used and a hemiarthroplasty was performed. Congruity, mechanical stability, significant improvement in the glenoid retroversion, generally excellent clinical results, and incorporation of the graft were achieved and no allograft failed because of early or late infection, nonunion at the graft-host junction, or instability.

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