Reverse shoulder arthroplasty using a "L" shaped allograft for glenoid reconstruction in a patient with massive glenoid bone loss: case report

Primary reverse total shoulder arthroplasty (RSA) has demonstrated to relieve pain, restore function and active elevation in patients with Cuff Tear Arthropathy. This condition of muscular imbalance could lead, in the long-term, to morphologic changes of the glenoid's anatomy. Insufficient bone stock of glenoid is a major challenge and without reconstruction, may be inadequate to support a glenoid component. Many authors have proposed the use of a bone graft in these cases and different techniques have been described to reconstruct severe bone loss of the glenoid but no ideal approach has currently been identified. We report the use of a "L" shaped frozen allograft for glenoid reconstruction in a patient with massive, uncontained glenoid bone loss, undergoing a reverse shoulder arthroplasty in a "one step" procedure. At 1-year follow-up both x-rays and CT showed graft incorporation with no resorption of bone and the patient reported continued stability of the shoulder and a high-level of satisfaction in terms of pain and function.