Addressing glenoid erosion in anatomic total shoulder arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Glenoid wear is a frequent complication of shoulder arthritis.
• Severe glenoid erosion presents significant challenges during shoulder arthroplasty.

Purpose of the Study:

• To review classification schemes for glenoid erosion.
• To evaluate six primary treatment options for shoulder arthroplasty in the presence of glenoid erosion.
• To propose a treatment algorithm based on the degree of glenoid erosion.

Main Methods:

• Review of existing literature on glenoid erosion classification.
• Analysis of treatment outcomes for six surgical options: eccentric reaming, bone grafting, inset glenoid, augmented glenoid component, hemiarthroplasty, and reverse shoulder arthroplasty.
• Development of a treatment algorithm.

Main Results:

• The paper details various classification systems for glenoid erosion.
• Outcomes for six distinct surgical interventions are presented.
• An algorithm is proposed to guide treatment selection based on erosion severity.

Conclusions:

• Managing severe glenoid wear during shoulder replacement is complex.
• Emerging techniques, such as augmented glenoid components and reverse shoulder arthroplasty with augmented baseplates, offer solutions for complex cases.