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. 2021 Mar 31;13(1):8605.
doi: 10.4081/or.2021.8605. eCollection 2021 Mar 30.

Shoulder arthroplasty in dwarfism: A case report of pseudoachondroplasia with 17-year follow-up

Gregory Gasbarro  1 , Joseph W Galvin  1 , Alexander Prete  1 , Ameen Barghi  1 , Aisha Obeidallah  1 , Jon J P Warner  1
Affiliations

Shoulder arthroplasty in dwarfism: A case report of pseudoachondroplasia with 17-year follow-up

Gregory Gasbarro et al. Orthop Rev (Pavia). .

Abstract

The purpose of this case report is to report the long-term outcome following shoulder hemiarthroplasty in a patient with dwarfism. A 60-year old female with pseudoachondroplasia dwarfism presented 17 years post-operative with a Subjective Shoulder Value of 90% and minimal pain. Custom designed implants were critical for surgical success. Preoperative planning with a CT scan was important in assessing glenoid dysplasia and determining the feasibility of glenoid resurfacing. The emergence of 3D CT virtual preoperative planning tools can further assist in the recognition of deformity to determine if custom designed implants are needed. Shoulder arthroplasty in dwarfism can lead to excellent long-term outcomes.

Keywords: Dwarfism; Hemiarthroplasty; Outcomes; Shoulder Arthroplasty.

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Conflict of interest statement

Conflict of interest: The authors declare no potential conflict of interest.

Figures

Figure 1.
Figure 1.
(A) Preoperative Grashey radiograph of the right shoulder shows severe humeral deformity and inferior glenoid inclination. (B) Preoperative computed tomography demonstrates glenoid dysplasia on axial cuts.
Figure 2.
Figure 2.
17-year right-sided postoperative range of motion assessment demonstrating: (A) forward flexion, (B) external rotation in abduction, (C) external rotation, and (D) internal rotation. Note, she has now developed degenerative glenohumeral disease on the left side, which prompted this clinic visit.
Figure 3.
Figure 3.
17-year postoperative (A) Grashey and (B) axillary lateral radiographs demonstrating a well-fixed hemiarthroplasty with progressive glenoid wear.
Figure 4.
Figure 4.
Preoperative 3D computed tomography planning example for a patient with achondroplasia demonstrates the need for smallest possible implants without custom design. (A) Retroversion, inclination, and posterior humeral head subluxation are automatically calculated. (B) Glenoid planning permits site modification and placement on the glenoid vault for maximal fixation. (C) This case permitted the use of a kneeled rather than pegged glenoid due to the small site of available glenoid bone stock. (D) Humeral planning allows for sizing and determination as to whether a stemmed or stemless implant can be used. (E) This screenshot shows the final plan and produces calculation of version and inclination correction.
Figure 5.
Figure 5.
Example of pre-operative positioning in the beach chair using a molded bean bag for support.
See this image and copyright information in PMC

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