Catastrophic failure of a low profile metal-backed glenoid component after total shoulder arthroplasty

The reverse design of the total shoulder arthroplasty has been utilized for elderly patients with severely degenerated glenohumoral joints that are rotator cuff deficient. One of the most common causes of failure in shoulder arthroplasty involves loosening or catastrophic failure of the glenoid component. Such problems can be related to suboptimal fixation due to bone loss from fractures, severe degenerative changes and from previous failed arthroplasty surgery [1]. This emphasizes the need to secure the glenoid component with sound screw purchase beyond the glenoid vault. However, such fixation can often be tenuous as scapula bone quality is heterogeneous with a wide variation across short distances [2, 3]. Moreover, it can be difficult to identify regions with the best bone stock intraoperatively. This often requires multiple passes with the drill, which leads to further bone loss and potential decreased screw purchase. Thus, it is important for the surgeon to have a firm understanding of scapular anatomy with potential screw trajectories in mind.

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Failure of the Glenoid Component in Anatomic Total Shoulder Arthroplasty

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.l.00552 ◽

2013 ◽

Vol 95 (24) ◽

pp. 2205-2212 ◽

Cited By ~ 95

Author(s):

Anastasios Papadonikolakis ◽

Moni Blazej Neradilek ◽

Frederick A Matsen

Keyword(s):

Shoulder Arthroplasty ◽

Total Shoulder Arthroplasty ◽

Glenoid Component

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Stable glenoid component of reverse total shoulder arthroplasty at 2 years as measured with model-based radiostereometric analysis (RSA)

Acta Orthopaedica ◽

10.1080/17453674.2021.1943932 ◽

2021 ◽

pp. 1-7

Author(s):

Alexander Nilsskog Fraser ◽

Berte Bøe ◽

Tore Fjalestad ◽

Jan Erik Madsen ◽

Stephan M Röhrl

Keyword(s):

Shoulder Arthroplasty ◽

Total Shoulder Arthroplasty ◽

Reverse Total Shoulder Arthroplasty ◽

Glenoid Component ◽

Radiostereometric Analysis ◽

Model Based ◽

Reverse Total Shoulder

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Glenoid Component Failure in Total Shoulder Arthroplasty

Yearbook of Hand and Upper Limb Surgery ◽

10.1016/s1551-7977(09)79290-8 ◽

2009 ◽

Vol 2009 ◽

pp. 20-21

Author(s):

N.D. Boardman III

Keyword(s):

Shoulder Arthroplasty ◽

Total Shoulder Arthroplasty ◽

Glenoid Component ◽

Component Failure

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Journey of the glenoid in anatomic total shoulder replacement

Shoulder & Elbow ◽

10.1177/1758573218790119 ◽

2018 ◽

Vol 11 (2) ◽

pp. 140-148 ◽

Cited By ~ 4

Author(s):

Alessandro Castagna ◽

Raffaele Garofalo

Keyword(s):

Shoulder Arthroplasty ◽

Current Practice ◽

Total Shoulder Arthroplasty ◽

Shoulder Function ◽

Patient Specific ◽

Glenoid Component ◽

Shoulder Replacement ◽

Final Destination ◽

Component Loosening

Anatomic total shoulder arthroplasty (TSR) has been shown to generate good to excellent results for patients with osteoarthritis and a functioning rotator cuff. Many studies have reported that the glenoid component loosening and failure remain the most common long-term complication of total shoulder arthroplasty. The approach to glenoid component is critical because a surgeon should consider patient-specific anatomy, preserving bone stock and joint line restoration, for a good and durable shoulder function. Over the years, different glenoid design and materials have been tried in various configurations. These include cemented polyethylene, uncemented metal-backed and hybrid implants. Although advances in biomechanics, design and tribology have improved our understanding of the glenoid, the journey of the glenoid component in anatomic total shoulder arthroplasty has not yet reached its final destination. This article attempts to describe the evolution of the glenoid component in anatomic TSR and current practice.

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