We would like to get a way to predict the need for glenoid bone-grafting in a reverse shoulder replacement planning
This can be achieved through pre-operative planning if you have a CT scan. The glenoid vault model - https://www.ncbi.nlm.nih.gov/pubmed/18328741 - described here can aid in determining there the native anatomy that existed prior to pathology.
A 3D printed model could be used to help prepare the graft to the appropriate size.
Outside of that its a bit more guess work.The baseplate is typically fit on the paleo-glenoid (the original glenoid surface remaining) in the ideal spot in terms of orientation and lateralization. The bone graft is then tailored to the void that remains.
Agree with the CT scan and other option is to measure in bone densitometry of the shoulder ( here in Argentina there is no software...) comparative if its possible...
If you have the possibility to make that...
best regards
Great question! Along with the CT scan answers to address glenoid bone loss, several surgeons around the world have recognized the advantage of moving the center of rotation of the glenoid baseplate laterally but still in bone to promote biologic remodeling and maximize rotator cuff function. We have been adding up to 10mm of bone graft to all reverse total shoulder procedures for more than 10 years now with outstanding results. These patients achieve better ROM and for patients that have a standard TSA on one side and an RSA with the graft on the other, they cannot tell the difference.
Orecurso ao TAC 3D permite fazer a avaliação do defeito ósseo pre operatoriamente; existem atualmente implantes "custom made" baseados nessa tecnologia. Mas o uso de enxertos ósseos, após estudo 3D, é comum e com excelentes resultados no longo prazo.
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