Aim

Excessive glenoid retroversion and posterior wear leads to technical challenges when performing anatomic shoulder replacement. Various techniques have been described to correct glenoid version, including eccentric reaming, bone graft, posterior augmentation and custom prosthesis. Clinical outcomes and survivorship of a Stemless humeral component with cemented pegged polyethylene glenoid with eccentric reaming to partially correct retroversion are presented.

Patients and Methods

Between 2010– 2019, 115 Mathys Affinis Stemless Shoulder Replacements were performed. 50 patients with significant posterior wear and retroversion (Walch type B1, B2, B3 and C) were identified. Measurement of Pre-operative glenoid retroversion and Glenoid component version on a post op axillary view was performed by method as described by Matsen FA. Relative correction was correlated with clinical and radiological outcome.

Results

4 were lost to follow up. 46 patients were therefore reviewed. The mean follow up was 4 years (2–8.9 years).

Walch B1, Pre op Retroversion: 12 (8–20), post op retroversion :11.8 (−4 to 19), correction= 0.2.

Walch B2, Pre op Retroversion :18.4 (10–32), post op retroversion: 13.2 (1 −22), correction= 5.2.

Walch B3, Pre op Retroversion: 19.1 (13–32)post op retroversion : 16.1 (9–25), correction= 3.0

Walch C, Pre op Retroversion: 33.3 (28–42) post op retroversion: 16.0 (6–27), correction= 17.3

3 patients required revision surgery for rotator cuff failure.

Conclusion

Partial correction of glenoid retroversion with eccentric reaming and implantation of cemented pegged polyethylene component leads to satisfactory clinical outcomes at midterm follow up. No revisions for aseptic loosening of the glenoid were required.