Addressing glenoid erosion in anatomic total shoulder arthroplasty

Glenoid wear is common in the setting of shoulder arthritis. Severe glenoid erosion presents a serious challenge to the surgeon performing a shoulder arthroplasty. This paper presents the various classification schemes for glenoid erosion. The results of the six main treatment options for shoulder arthroplasty with an eroded glenoid are reviewed. The six treatment options include: 1. eccentric reaming, 2. bone grafting, 3. use of inset glenoid, 4. use of an augmented (asymmetric) glenoid component, 5. hemiarthroplasty, and 6. reverse shoulder arthroplasty. A treatment algorithm is proposed based on the amount of glenoid erosion. Severe glenoid wear resulting in the need for shoulder replacement surgery is a challenge; however, new tools for dealing with this complicated entity are rapidly evolving, including the use of augmented anatomic glenoid components and reverse shoulder arthroplasty with augmented baseplates.