Symptomatic Glenoid Loosening Complicating Total Shoulder Arthroplasty

Bradley S. Raphael, MD
Department of Orthopedic Surgery, Hospital for Special Surgery


Joshua S. Dines, MD

Joshua S. Dines, MD

Assistant Attending Sports Medicine and Shoulder Service, Hospital for Special Surgery
Clinical Assistant Professor of Orthopaedic Surgery, Weill Cornell Medical College

Russell F. Warren, MD

Russell F. Warren, MD

Attending Orthopaedic Surgeon, Hospital for Special Surgery
Surgeon-in-Chief Emeritus, Hospital for Special Surgery
Professor of Orthopaedic Surgery, Weill Cornell Medical College

Mark P. Figgie, MD

Mark P. Figgie, MD

Chief of the Surgical Arthritis Service, Hospital for Special Surgery
Associate Attending Orthopaedic Surgeon, Hospital for Special Surgery
Associate Professor of Orthopaedic Surgery, Weill Cornell Medical College

Edward V. Craig, MD, MPH

Edward V. Craig, MD, MPH

Attending Orthopaedic Surgeon, Sports Medicine and Shoulder Service, Hospital for Special Surgery
Professor of Clinical Surgery, Weill Cornell Medical College

Stephen Fealy, MD

Stephen Fealy, MD

Associate Attending Orthopaedic Surgeon, Hospital for Special Surgery
Associate Professor of Orthopaedic Surgery, Weill Cornell Medical College

David M. Dines, MD

David M. Dines, MD

Attending Orthopaedic Surgeon, Hospital for Special Surgery
Professor, Weill Cornell Medical College
Chairman and Professor of Orthopedic Surgery, Albert Einstein College of Medicine at LIJ

Abstract

Glenoid component loosening is one of the most common causes of failed total shoulder arthroplasty. Previous reports indicate that it is desirable to reimplant the glenoid component during revision shoulder arthroplasty. The purpose of our study was to retrospectively evaluate the satisfaction of patients undergoing glenoid revision (reimplantation or resection) following total shoulder replacement specifically for symptomatic glenoid loosening. Twenty-eight shoulders that developed symptomatic glenoid loosening following primary total shoulder arthroplasty were included in the study. Patients were retrospectively evaluated at a minimum of 2 years postoperatively. Patients either underwent resection followed by reimplantation of the glenoid component (13) or resection of the component with or without bone grafting (15). Each patient was evaluated with the UCLA Shoulder Scale and the Constant–Murley Shoulder Assessment. There were seven excellent, 13 good, five fair and three poor results on the UCLA score. Functional outcome scores trended higher in the reimplantation group but were not statistically significant. Both groups reported equal pain relief and satisfaction. Five out of 15 patients underwent arthroscopic resection of the glenoid, and these patients scored as well on the UCLA and Constant scores as the reimplantation group. When symptomatic glenoid loosening is the indication for revision total shoulder replacement, patients tend to achieve good to excellent results. Though functional scores were slightly higher in the reimplantation group, satisfaction was equally high in both groups. Resection, when indicated, should be performed arthroscopically as this improved functional outcome in our series.

This article appears in HSS Journal: Volume 6, Number 1.
View the full article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.

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