A Sequential Approach to the Management of Posterior Glenoid Defects in RSA : Angulated BIO Versus Multiple Bioresorbable Pinning-Assisted Structural Bone-Grafting.

Background:Large posterior glenoid defects pose problems in reverse shoulder arthroplasty (RSA). We have adopted asequential approach to the management of posterior glenoid defects using asymmetrical reaming, the placement of a ring graft around the central peg (bony-increased offset, or BIO), or structural bone-grafting, depending on the amount of glenoid retroversion. Furthermore, we have devised multiple bioresorbable pinning (MBP)-assisted bone-grafting, in which as many bioresorbable pins as required are inserted, from whichever aspects of the graft necessary, to achieve initial stability.Methods:We reviewed 52 shoulders with posterior glenoid defects undergoing RSA between 2014 and 2019 (mean follow-up, 4.8 years; range, 2 to 6 years). Twenty (38.5%) of the shoulders had glenoid retroversion of <15° and were treated by asymmetrical reaming (Group A), 19 (36.5%) of the shoulders had retroversion of ≥15° to