Diagnostics and methods of solving the reduction of bone mineral density and deformities of the articular cavity of the scapula during reverse shoulder arthroplasty

Abstract

Background. Reverse arthroplasty is an effective method of treating severe injuries and diseases of the shoulder joint. In cases of severe osteoporosis, defects and deformities of the glenoid, there are risks of incorrect installation and instability of the components of the endoprosthesis. In the literature data, the problem of osteoporosis in the endoprosthetics of the shoulder joint and methods of its solution are rather poorly reflected, which was the reason for this study.The aim: to develop algorithms for diagnosing the state of the bone tissue of the articular cavity of the scapula and methods for solving its deviations during reverse shoulder arthroplasty.Materials and methods. Forty-eight patients who underwent reversible shoulder joint replacement were examined in the Department of Adult Orthopedics of the N.N. Priorov National Medical Research Center of Traumatology and Orthopedics. A standard preoperative examination of patients developed in the department was performed, as well as additional calculations of bone density in Hounsfield units and according to X-ray densitometry were performed. The parameters of bone density of the glenoid (in HU) were compared with the data of densitometry.Results. According to the results of densitometry, the patients were divided into groups. A direct dependence of the bone density of the glenoid and the indicators of densitometry was revealed. Algorithms of treatment and preoperative preparation of patients with bone density deficiency for reverse shoulder arthroplasty have been developed.Conclusions. In the studied groups, 100 % of patients with indicators below 139 HU were diagnosed with osteoporosis or osteopenia, and patients with more than 257 HU had normal bone mineral density.

Keywords

• omarthrosis
• reverse arthroplasty
• osteoporosis
• densitometry
• computed tomography