Anatomic Augmented Glenoid Implants for the Management of the B2 Glenoid

Abstract

The B2 glenoid is defined by Walch et al. as a glenoid that is biconcave with posterior erosion accompanied by posterior humeral head subluxation. This creates unique challenges for the treating orthopedic surgeon. Bone loss, excessive retroversion, and posterior subluxation make anatomic shoulder arthroplasty in this setting fraught with increased complications, including instability, glenoid component loosening, and poor clinical outcomes. Many techniques have been devised to treat the arthritic shoulder with a B2 glenoid, including hemiarthroplasty, total shoulder arthroplasty using eccentric reaming, bone grafting and custom implantation, and reverse total shoulder arthroplasty. In this review, we will focus on anatomic total shoulder arthroplasty using augmented glenoid implants to treat the B2 glenoid. Indications, clinical results, and basic science analyses of augmented anatomic glenoids are also discussed.

Keywords: Arthritis; arthroplasty; osteoarthritis; prosthesis; replacement; shoulder.

Figure 1.

The Cofield 2 glenoid augment (Smith and Nephew, Inc, Memphis, TN). Image courtesy of Grant E. Garrigues, MD.

Figure 2.

The Step-Tech glenoid augment (DePuy Orthopaedics, Warsaw, IN). Image courtesy of Grant E. Garrigues, MD.

Figure 3.

The Equinoxe glenoid augment (Exactech, Gainesville, FL). Image courtesy of Grant E. Garrigues, MD.

Figure 4.

Forty-eight year old motocross racer with severe osteoarthritis with B2 glenoid morphology treated with anatomic total shoulder arthroplasty with Perform + glenoid augment (Tornier/Wright Medical, Memphis, TN). Image courtesy of Grant E. Garrigues, MD.