Mehta Siddhant K, Keener Jay D
Department of Orthopaedic Surgery, Washington University in Saint Louis School of Medicine, St. Louis, Missouri.
J Shoulder Elb Arthroplast. 2019 Jul 30;3:2471549219865786. doi: 10.1177/2471549219865786. eCollection 2019.
The Walch B2 glenoid is characterized by a biconcave glenoid deformity, acquired glenoid retroversion, and posterior subluxation of the humeral head. Surgical reconstruction of the B2 glenoid is often challenging due to the complexity of the deformity. Bone graft augmentation using humeral head autograft is a valuable adjunct to anatomic total shoulder arthroplasty in the B2 glenoid, particularly in the young, highly active patient with severe glenoid retroversion (>25°-30°). Although this technique affords the ability to correct glenoid version and simultaneously enhances glenoid bone stock, it is technically challenging. The potential for graft-related complications also exists, which may further impact glenoid implant longevity and functional outcome. This review article aims to describe the B2 glenoid morphology, discuss the challenges in managing the B2 deformity, and provide further insight specifically regarding autografting at the time of anatomic total shoulder arthroplasty for reconstruction of the B2 glenoid.
Walch B2型肩胛盂的特征为双凹形肩胛盂畸形、获得性肩胛盂后倾以及肱骨头后脱位。由于畸形的复杂性，B2型肩胛盂的手术重建往往具有挑战性。使用自体肱骨头进行骨移植增强是B2型肩胛盂解剖型全肩关节置换术中一种有价值的辅助方法，尤其适用于肩胛盂严重后倾（>25°-30°）的年轻、活动量大的患者。尽管该技术能够纠正肩胛盂的角度并同时增加肩胛盂的骨量，但在技术上具有挑战性。还存在与移植相关的并发症的可能性，这可能会进一步影响肩胛盂植入物的使用寿命和功能结果。这篇综述文章旨在描述B2型肩胛盂的形态，讨论处理B2型畸形的挑战，并特别深入探讨在解剖型全肩关节置换术时进行自体骨移植以重建B2型肩胛盂的相关问题。
