CHAPTER 10 Glenoid Exposure
Whenever we question surgeons who routinely perform hemiarthroplasty instead of total shoulder arthroplasty for conditions such as primary osteoarthritis about why they chose not to resurface the glenoid, by far the most common response is that they encounter problems with glenoid exposure. When questioned further, it is evident that most of these surgeons simply lack the information necessary to correctly and reliably provide visualization of the osseous glenoid. Glenoid exposure can be simplified by following a sequence of surgical steps. This chapter outlines our systematic technique of capsular release that provides sufficient visualization for glenoid resurfacing.
TECHNIQUE FOR GLENOID EXPOSURE
Anterior Release
After the subscapularis is retracted medially with a sponge and small glenoid rim retractor, attention is turned to glenoid exposure. A needle tip electrocautery is used to excise any remaining labrum beginning at the base of the coracoid process and extending inferiorly to the 5 o’clock position in a right shoulder (7 o’clock in a left shoulder). This allows identification of the osseous anterior margin of the glenoid (Fig. 10-1).
