The B2 glenoid is defined by Walch et al. as a glenoid that is biconcave with posterior erosion accompanied by posterior humeral head subluxation. This creates unique challenges for the treating orthopedic surgeon. Bone loss, excessive retroversion, and posterior subluxation make anatomic shoulder arthroplasty in this setting fraught with increased complications, including instability, glenoid component loosening, and poor clinical outcomes. Many techniques have been devised to treat the arthritic shoulder with a B2 glenoid, including hemiarthroplasty, total shoulder arthroplasty using eccentric reaming, bone grafting and custom implantation, and reverse total shoulder arthroplasty. In this review, we will focus on anatomic total shoulder arthroplasty using augmented glenoid implants to treat the B2 glenoid. Indications, clinical results, and basic science analyses of augmented anatomic glenoids are also discussed.
Total shoulder arthroplasty with nonspherical humeral head and inlay glenoid replacement: clinical results comparing concentric and nonconcentric glenoid stages in primary shoulder arthritis