On the faculty in Melbourne
Invited as faculty to the DePuy Delta Extend Conference in Melbourne, with two presentations.
Wedge allografts in the retroverted glenoid
The first talk reported early results in patients with osteoarthritis and severe B2 glenoids, meaning a socket worn unevenly at the back, treated with a bone graft taken from the excised humeral head together with a reverse total shoulder replacement.
The series was small and the follow-up short: the average age was 68, average follow-up was 14 months, and only six patients had reached a minimum of one year. The reported average scores before and after surgery were:
- Pain (VAS): 60 before, 8 after.
- Oxford Shoulder Score: 18 before, 42 after.
- QuickDASH: 57 before, 16 after.
- Satisfaction: 30 before, 88 after.
These are early results from a small series without a comparison group, presented at a conference rather than published. They should be read as preliminary. Individual results vary.
Deltoid reflection
The second talk concerned reflecting the anterior deltoid during reverse shoulder replacement, with the aim of protecting it from injury while improving exposure. Two groups were compared, the first comprising 18 patients in whom the deltoid was reflected. No difference in Oxford scores was found between the groups, and ultrasound at one year showed the reattached deltoid had healed.
Again the numbers are small, and a finding of no difference in a group of this size does not establish equivalence. The work indicates the technique is worth studying further rather than that it is established.
Related information
See our reverse total shoulder replacement page, and our posts on deltoid reflection at EFORT and augmented glenoid components.