Treatment of Glenoid Bone Deficiency in Total Shoulder Arthroplasty: A Critical Analysis Review.

The rate of total shoulder arthroplasty has increased over the last decade. More total shoulder arthroplasties than hemiarthroplasties have been performed annually since 20061. The projected number of total shoulder arthroplasty procedures has been predicted to increase by 192% to 322% from 2007 to 20152. A meta-analysis of patient quality-of-life scores after anatomic total shoulder arthroplasty showed improvement in both physical and pain-related scores, with the greatest improvement in shoulder-specific questionnaires3. With worsening severity of posterior bone loss, the glenoid typically becomes more retroverted. Posteriorly worn glenoids are associated with posterior instability after total shoulder arthroplasty4. Hopkins et al.5 found that retroverted glenoid components may be more susceptible to loosening after total shoulder arthroplasty. Glenoid component retroversion also has been correlated with diminished shoulder function and decreased range of motion6,7. Because of the prevalence of glenoid bone loss in patients with arthritic shoulder conditions, various techniques have been developed to address this issue. One such technique is to not implant a glenoid component at all. However, humeral hemiarthroplasty in patients with a degenerative glenohumeral joint has failed to show acceptable …