Glenohumeral Arthrodesis



Glenohumeral Arthrodesis


Robin R. Richards



INTRODUCTION

The advent of total shoulder arthroplasty and the refinement of other reconstructive procedures have narrowed the indications for glenohumeral arthrodesis.50 Nevertheless, arthrodesis of the glenohumeral joint continues to provide a valuable method of shoulder reconstruction for specific indications.19,29,80 Although the procedure is infrequently performed, it reliably provides patients with a stable, strong shoulder. Albert first attempted glenohumeral arthrodesis in 1881. Since then a voluminous literature has evolved outlining different indications for the procedure and a variety of surgical techniques for performing glenohumeral arthrodesis. Controversies have developed in the literature about the indications for the procedure and the optimum position for glenohumeral arthrodesis.2,62 More recently, discussion has arisen of the functional results that can be achieved with the procedure.15,30 In this chapter, the complex and revision problems are addressed and then the complications and the results of glenohumeral arthrodesis are discussed.

Arthrodesis is an important method of shoulder reconstruction. The procedure has stood the test of time and continues to deserve a place in the shoulder surgeon’s armamentarium. For certain specific indications, it provides the best method of restoring function to the shoulder.




CONTRAINDICATIONS TO GLENOHUMERAL ARTHRODESIS

Glenohumeral arthrodesis should not be performed if an alternative method of shoulder reconstruction is available. Many patients are amenable to arthroplastic reconstruction that preserves glenohumeral motion and has greater potential to restore function. Glenohumeral arthrodesis places a significant functional demand on the patient, requiring a major effort on
the part of the patient to rehabilitate the shoulder following surgery and to strengthen the thoracoscapular musculature. The procedure is contraindicated in a patient who cannot cooperate with such a program of rehabilitation. Similarly, the procedure is contraindicated in any patient with a progressive neurologic disorder who may experience paralysis or weakness of the trapezius, levator scapula, or serratus anterior. Glenohumeral arthrodesis relies on these muscles to motor the extremity, and significant weakness will grossly impair shoulder function following the procedure.


Jul 9, 2016 | Posted by in ORTHOPEDIC | Comments Off on Glenohumeral Arthrodesis

Full access? Get Clinical Tree

Get Clinical Tree app for offline access