Patient-specific instrumentation guides shoulder surgery solutions for glenoid bone loss

A 69-year-old male with a long-standing history of shoulder pain and loss of function was referred to Mayo Clinic due to severe glenoid bone loss, thought by his home clinic to be a contraindication for shoulder arthroplasty.

Complexity

Glenoid bone insufficiency can jeopardize shoulder surgery outcomes by offering too little bone stock for secure component implantation.

Solution

The Mayo Clinic shoulder section excels in complex and revision surgery, and is among the leaders worldwide refining and cautiously expanding reverse shoulder arthroplasty (RSA) reconstructions. RSA reverses the natural anatomy of the ball-and-socket joint by implanting a concave socket into the humeral head, and a convex spherical glenoid component into the glenoid fossa. Improved component fixation together with precise placement of the components allows surgeons to overcome severe glenoid bone loss.

Mayo's research-based clinical practice was one of the first to pioneer patient-specific instrumentation made with custom CT scans of the shoulder to aid precise component placement and improve outcomes.

Outcome

The patient obtained a highly successful, pain-free recovery as a result of the integrated care provided by a highly skilled team, customized instrumentation and Mayo Clinic's postoperative physical therapy protocols. John W. Sperling, M.D., shoulder specialist at Mayo Clinic in Rochester, Minn., notes:: "Patient-specific instrumentation is a major advance in shoulder arthroplasty. It provides intraoperative flexibility for the surgeon to choose between anatomic and reverse arthroplasty. In addition, it facilitates more predictable and accurate component placement in shoulder arthroplasty, which substantially improves the likelihood of an optimal outcome."

Feb. 11, 2014