Orthopedic Surgeon Paul Favorito, MD
Mercy Health – Cincinnati, which provides advanced, quality, compassionate care in your neighborhood through its care network, announces that orthopedic surgeon and shoulder specialist Paul Favorito, MD, who practices with Mercy Health – Wellington Orthopaedics and Sports Medicine, has published the first paper of its kind in the peer-reviewed, Journal of Shoulder and Elbow Surgery.

Many patients are candidates for traditional shoulder replacement surgery that replaces both the ball and the socket.

However, some patients present with advanced shoulder arthritis and loss of some of the glenoid (socket bone). Substantial bone loss may compromise the results of shoulder replacement using traditional components.

“If you think of the head of the shoulder as a ball that fits into a shallow cup, the loss of protective cartilage around the ball causes it to wear away the back of the socket,” says Dr. Favorito. “The optimal treatment for these patients is unclear. Until recently, patients with glenoid bone loss were poor candidates for total shoulder replacement because there was insufficient bone to support a socket component. Patients who chose partial shoulder replacements continued to have pain and further wear of the eroded bone.”

DePuy Synthes, which makes reconstructive joints, addressed the issue with a stepped socket.

Dr. Favorito’s research reported on patient outcomes following shoulder replacement using the stepped socket. The component builds up the socket and substitutes for the missing bone. To date, Dr. Favorito has performed over 50 of these replacements since it was first approved for use by the Food and Drug Administration in 2011. He reported on the first 22 shoulder replacement patients who had the surgery between 2011 and 2013 and had at least two years of follow up.

“I can confirm this device works well for patients with advanced arthritic bone loss identified with x-rays and then further defined with a CT scan,” he says. “Replacements using this device provided important gains in quality of life and initial results are similar to shoulder replacements in patients who do not have bone loss. We will continue to follow the patients to monitor their progress and assess the longevity of the component.”

While patients with bone loss now have a better option available to them, Dr. Favorito urges patients with shoulder pain to see a specialist sooner rather than later since surgery with the stepped socket is more complex and the long term results are unknown.

“Up to 15-20% of patients have bone loss that needs management,” he says. “The longer you wait, the more damage there will be and the more limited your options for relief.”

Dr. Favorito practices from Mercy Health – Wellington Orthopaedics and Sports Medicine locations in Anderson and Eastgate. For more information on shoulder replacement or to make an appointment, please call 513-232-6677.

The Journal of Shoulder and Elbow Surgery published Dr. Favorito’s research, titled Total shoulder arthroplasty for glenohumeral arthritis associated with posterior glenoid bone loss: results of an all-polyethylene, posteriorly augmented glenoid component, available online May 2016.