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Abstract：
Reverse Total Shoulder Arthroplasty is being increasingly performed, with indications in both elective and trauma settings. Accordingly, there are an increasing number of revision cases where glenoid bone loss is a concern. There are well recognised surgical techniques for dealing with mild to moderate glenoid wear, including eccentric reaming and impaction grafting. In cases of severe wear or uncontained glenoid defects these may not be suitable, and the surgeon may look to a customised implant to deal with such bone loss. There are several implant manufacturers who currently market and produce patient specific instrumentation and customised glenoid baseplates to achieve the best possible fixation in cases of severe bone loss. This article outlines some examples of custom implants currently available to surgeons, and the process by which they may be procured and used. Implant and surgical considerations, and key aspects of surgical technique are also covered. Literature on outcomes and complications following custom shoulder arthroplasty shows promising results, but at present is limited to relatively small case series with no long-term outcome data.
摘要：
反向全肩关节成形术越来越多，在选修和创伤设置中都有适应症。因此，越来越多的翻修病例关注关节盂骨丢失.有公认的手术技术来处理轻度至中度的关节盂磨损，包括偏心扩孔和嵌塞嫁接。在严重磨损或未包含的关节盂缺损的情况下，这些可能不适合，外科医生可能会寻求定制的植入物来处理这种骨质流失。目前有几家植入物制造商销售和生产患者专用仪器和定制的关节盂基板，以在严重骨丢失的情况下实现最佳的固定。本文概述了目前可供外科医生使用的定制植入物的一些示例，以及采购和使用它们的过程。植入和手术的考虑，还涵盖了手术技术的关键方面。关于常规肩关节置换术后的结果和并发症的文献显示了有希望的结果，但目前仅限于相对较小的病例系列，没有长期结果数据。
