Shoulder arthroplasty for osteoarthritis secondary to glenoid dysplasia: an update

Glenoid component fixation is an issue in shoulder arthroplasty for glenoid dysplasia with osteoarthritis because of the small amount of bone available. In 2002, we described 6 patients (7 shoulders) undergoing shoulder arthroplasty for this condition. This report expands that experience to further understand the role of anatomic shoulder arthroplasty (both hemiarthroplasty and total shoulder arthroplasty), to outline results, and to identify complications and reoperations-all to better understand whether other treatment options need to be developed and explored. Our hypothesis is that treatment of this problem with anatomic arthroplasty is not ideal.

Between 1980 and 2008, 20 patients (22 shoulders) underwent anatomic shoulder arthroplasty for treatment of osteoarthritis secondary to glenoid dysplasia. There were 8 hemiarthroplasties and 14 total shoulder arthroplasties. Average follow-up was 6 years (range, 0.4 to 23.1 years).

Pain was relieved in 4 of 8 shoulders undergoing hemiarthroplasty and in 10 of 14 shoulders undergoing total arthroplasty. Mean active elevation improved from 96° to 125°, and external rotation improved from 19° to 42°. Motion improvements were similar for hemiarthroplasty and total shoulder arthroplasty. Four shoulders having hemiarthroplasty underwent revision surgery because of painful glenoid arthrosis. Two shoulders with total arthroplasty underwent revision for infection, and 3 underwent revision for glenoid component issues.

Favorable results can be obtained with the use of anatomic implants in the treatment of glenoid dysplasia. However, continuing subluxation, glenoid arthrosis, and glenoid component problems necessitating revision surgery are frequent. Alternative treatment methods should be considered.