Reverse Shoulder Arthroplasty, Patient-Specific Custom Glenoid Implant

Patient Overview: 

A 74-year-old female with long-standing rheumatoid arthritis presented with progressive pain and functional limitation of the left shoulder. The patient had significant systemic involvement in rheumatoid disease and had previously undergone bilateral total knee replacements for advanced arthropathy. 

One year earlier, she underwent right reverse shoulder arthroplasty at our centre, achieving excellent pain relief and full functional range of motion with high patient satisfaction. However, over the past few months, she developed worsening pain and restricted movement in the left shoulder, significantly impacting her daily activities and quality of life. 

Clinical Evaluation:

Clinical examination revealed marked restriction of both active and passive shoulder movements with pain at end ranges. 

CT imaging of the left shoulder demonstrated severe glenoid bone loss with a markedly small and dysplastic glenoid. The limited bone stock made implantation of a standard glenoid base plate unsuitable and posed a high risk for implant instability or failure using conventional reverse shoulder arthroplasty techniques. 

Reverse Shoulder Arthroplasty Surgical Planning: 

A CT-based 3D planning workflow was used to evaluate residual bone stock and reconstruct glenoid anatomy digitally. Based on this analysis, a customized ReGlen implant was designed and manufactured by the JMS design team to achieve optimal alignment and stable fixation. 

Custom Glenoid Implant Design:

A patient-specific 3D-printed titanium glenoid implant was developed to match the patient’s unique anatomy and compensate for the severe bone loss. 

Key Design Features ReGlen – Patient Specific Glenoid Implant: 

Custom-fit geometry designed to restore the deficient glenoid anatomy. 

Augmented base plate structure to compensate for bone deficiency. 

Porous lattice surface to promote osseointegration and long-term fixation. 

Optimized central peg fixation and screw orientation targeting areas of maximum bone stock for improved implant stability. 

Along with the custom implant, patient-specific surgical jigs were designed based on preoperative 3D planning. These guides enabled accurate positioning of the glenoid base plate and optimized screw trajectory, ensuring precise execution of the planned reconstruction.  

Post-operative Outcome of Patient-Specific Glenoid Implant:  

The customized implant was successfully implanted, achieving stable fixation and accurate glenoid reconstruction. Postoperative imaging confirmed proper implant positioning with a stable foundation for reverse shoulder arthroplasty. 

    

Clinical Impact of ReGlen:  

This case demonstrates the value of patient-specific 3D-printed implants in managing complex shoulder arthroplasty cases with severe glenoid bone loss. Through advanced imaging, personalized implant design, and precision manufacturing, a customized solution enabled successful reconstruction where conventional implants were not feasible.