Shoulder arthroplasty for the management of glenoid dysplasia: a systematic review

Glenoid dysplasia (GD) is a developmental anomaly associated with early development of glenohumeral osteoarthritis. In this cohort, shoulder arthroplasty remains a technically challenging operation due to associated bony deficiency and excessive retroversion. This systematic review aimed to evaluate the clinical and radiographic outcomes, assess the incidence of complications, and measure satisfaction following shoulder arthroplasty for the management of glenohumeral osteoarthritis in patients with GD.

A computerized search of MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus, with manual screening of selected article reference lists, was performed in July 2024. Studies examining associations between GD and clinical outcome, radiographic results, complications, reoperations, or patient satisfaction following anatomic total shoulder arthroplasty (aTSA), reverse total shoulder arthroplasty (rTSA), or shoulder hemiarthroplasty (HA) were included. Methodological quality was assessed using a modified Newcastle-Ottawa scale.

Seven studies with a mean modified Newcastle-Ottawa scale score of 10.9 ± 1.3 were included, consisting of 84 aTSA, 13 rTSA, and 22 HA cases in total. Over 2.3-8.5 years of follow-up, the majority of patients experienced marked improvements in shoulder function and pain, demonstrating good to excellent clinical assessment scores and range of motion. Glenoid lucent lines (55.6%), asymptomatic calcification of the triceps insertion (30.8%), and glenoid erosion (31.8%) represented the most common radiographic abnormalities following aTSA, rTSA, and HA, respectively. Complications and reoperations were present at rates of 9.2% and 12.3%, respectively. However, more than 80% of patients considered their level of satisfaction to be good or excellent.

Shoulder arthroplasty represents a safe and reliable option for the management of symptomatic GD, offering improved clinical outcomes and favorable satisfaction following surgery. Special attention must still be taken to surgically address the bony deficiency and retroversion associated with GD to mitigate the risk of complication and reoperation.