2.1.1. Deltopectoral Approach

In the first group, a standard deltopectoral approach with subscapularis tenotomy was performed. After dislocation of the humeral head, resection was obtained at the level of the anatomic neck. The trunion size was then determined using a template, and the length of the cage screw was measured using a special cage screw sizer. Then, a complete exposure of the glenoid articular surface was obtained by releasing the labrum and the capsule. The size of the glenoid (small, medium, or large) was assessed by choosing the glenoid guide that best matched the glenoid surface area. The guide pin was then inserted through the guide into the glenoid vault until it reached the medial cortical bone. After removal of the guide, the inserted pin was cut at the level of the glenoid surface, leaving the rest of the pin in the glenoid vault to allow for later radiological evaluation of the appropriate pin positioning, as well as the pin version and inclination. No glenoid implantation was performed; however, prior to cutting the pin, a reamer was inserted in order to evaluate the theoretical level of difficulty to ream the glenoid without actually reaming the bony surface. The definitive trunion was then implanted onto the resection plane, and the definitive cage screw was inserted followed by the appropriate size humeral head. The sizing and positioning of the implant was performed in a manner representative of the current standard of care in clinical practice.
