Does glenoid version and its correction affect outcomes in anatomic shoulder arthroplasty? A systematic review

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Glenoid retroversion correction is common in anatomic total shoulder arthroplasty (TSA) for improved component contact and reduced eccentric loading.
• Limited data exists on the clinical benefits of correcting glenoid retroversion despite biomechanical advantages.

Purpose of the Study:

• To systematically review the literature on the impact of preoperative and postoperative glenoid retroversion on clinical and radiologic outcomes in anatomic TSA.

Main Methods:

• A systematic literature review was conducted using PubMed, Embase, and Cochrane Library.
• Included English-language studies (Level I-IV evidence) were screened by blinded reviewers.
• Methodological quality was assessed using the Modified Coleman Methodology Score.

Main Results:

• Sixteen studies (1211 shoulders) were included; 9 used corrective reaming, 4 used augmented glenoids, and 2 used noncorrective reaming.
• Most studies (8/11) found no significant association between glenoid retroversion and clinical outcomes (PROs, ROM, failure rates).
• Radiographic outcomes were analyzed in 10 studies, with only one showing a significant effect of retroversion on Central Peg Lucency (CPL).

Conclusions:

• Insufficient evidence suggests pre- or postoperative glenoid version independently influences outcomes.
• Noncorrective reaming showed favorable outcomes, and postoperative version was not consistently linked to outcomes.
• There is inconclusive evidence supporting the routine correction of glenoid retroversion in TSA.