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Spherical Glenoid Reaming With Humeral Hemiarthroplasty: A Nonprosthetic, Orthobiologic Approach to Shoulder Arthroplasty

Parsons, I M. IV M.D.; Weldon, Edward J. III M.D.; Matsen, Frederick A. III M.D.

Techniques in Orthopaedics: March 2007 - Volume 22 - Issue 1 - p 62-70
doi: 10.1097/01.bto.0000261733.32889.69
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Problems associated with the glenoid component, including loosening, wear, and fracture, represent one of the leading causes of total shoulder failure. Humeral hemiarthroplasty with spherical glenoid reaming avoids problems with prosthetic glenoid resurfacing and creates a smooth, intrinsically stable concavity. Basic science studies have demonstrated that tissue resembling fibrocartilage forms in areas of protected space after spherical reaming and that the bone remodels into a homogenous and stable subsurface foundation. Remodeling is molded by articulation with the convex humeral prosthesis and permits optimal load distribution. This treatment alternative has shown clinical promise in younger and physically demanding patients. Through continued innovations in surgical technique, tissue engineering and biomaterials, this orthobiologic approach to shoulder arthroplasty may ultimately solve the problem of glenoid failure.

From the Seacoast Orthopedics and Sports Medicine, Somersworth, New Hampshire; Department of Orthopaedics, Straub Clinic, Honolulu, Hawaii; and the Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington.

Address correspondence and reprint requests to I. M. Parsons, IV, M.D., Seacoast Orthopedics and Sports Medicine, 237 Route 108, Suite 205, Somersworth, NH 03878. E-mail: impiv@comcast.net

© 2007 Lippincott Williams & Wilkins, Inc.