Glenoid revision surgery after total shoulder arthroplasty

Forty-eight shoulders that underwent glenoid component revision surgery were reviewed at a mean of 4.9 years (range, 2 to 12 years). The indications for surgery were glenoid component loosening in 29 shoulders, glenoid implant failure in 14 shoulders, and glenoid component malposition or wear leading to instability in 5 shoulders. Seventeen shoulders had associated instability. Thirty shoulders underwent implantation of a new glenoid component and 18 underwent removal of the component and bone grafting for bone deficiencies. There was significant pain relief, improvement in active elevation and external rotation, and satisfaction with revision glenoid surgery (P <.05). Patients without a glenoid component were significantly less satisfied with the procedure than those patients who underwent reimplantation of a glenoid component (P =.01). Satisfactory pain relief was achieved in 86% of patients with a new glenoid component and 66% of patients who underwent glenoid component removal. Seven shoulders with a new glenoid component (2 for glenoid loosening) and 5 who underwent removal without reimplantation (3 for painful glenoid arthritis) required re-revision surgery. Eleven of the 17 patients with instability were stable at the most recent follow-up. The data from this study suggest that at the time of revision glenoid surgery, patients who have placement of a glenoid component have a higher degree of satisfaction than those undergoing glenoid component removal. Patients who continue to have pain after bone grafting without placement of a component may be candidates for glenoid component placement after graft consolidation.