Primary total shoulder arthroplasty in the setting of anterior glenoid wear

Background

Anterior glenoid wear is an uncommon pattern of glenohumeral arthritis. This study sought to report outcomes after primary anatomic total shoulder athroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) in this patient cohort.

Methods

Operative notes of patients treated with primary aTSA or rTSA over a 16-year period were reviewed for patients with anterior glenoid wear noted intraoperatively. Preoperative computed tomography scans were measured to determine version. Patient-reported outcome measures, range of motion, strength, and complications were measured at a minimum of 2 years postoperatively.

Results

1.9% (51/2,712) of patients treated with primary shoulder arthroplasty during the study period were noted to have anterior glenoid wear. Thirty-seven patients had a minimum of 2-year follow-up (12 aTSA; 25 rTSA). Patient-reported outcome measures improved in both cohorts from baseline, without difference noted between groups. Both groups reported improvements in range of motion at final follow-up with the exception of internal rotation, which demonstrated no improvement in either group. One patient treated with aTSA underwent revision to rTSA for a loose glenoid and subscapularis insufficiency. A second developed subscapularis insufficiency but was successfully treated nonoperatively. In the rTSA cohort, two patients sustained acromion fractures, both of which were successfully treated nonoperatively. A third patient sustained a traumatic periprosthetic humeral fracture requiring revision.

Conclusion

Patients treated with either aTSA or rTSA reported successful outcomes at a minimum of 2-year follow-up.