Retrospective review of 215 anatomic total shoulder arthroplasties revised for symptomatic glenoid component failure at a tertiary shoulder center. The study asked which surgeon-controlled factors are associated with failure severe enough to require revision. It characterized failure modes, component designs, and glenohumeral centering at the time of revision.
Read glenoid failure as a chain of eccentric loading. When the humeral head sits off-center, the glenoid rocks and loads unevenly, producing the rocking-horse loosening and eccentric wear seen in half these shoulders.
That gives you two intraoperative levers: seat and fix the glenoid on accurately prepared bone (no backside cement), and center the humeral head with soft-tissue balancing and correct component position. Design choice matters. Metal-backed and keeled glenoids failed with more loosening, malposition, dislocation, and early failure than pegged all-polyethylene designs, consistent with registry data.
When soft-tissue deficiency makes centering impossible, choose a reverse total shoulder rather than fighting an anatomic glenoid that will rock loose. One caution: this is a revision-only case series with no denominator, so it identifies associations, not true failure rates.
Retrospective review of 215 anatomic total shoulder arthroplasties revised for symptomatic glenoid component failure at a tertiary shoulder center. The study asked which surgeon-controlled factors are associated with failure severe enough to require revision. It characterized failure modes, component designs, and glenohumeral centering at the time of revision.
Read glenoid failure as a chain of eccentric loading. When the humeral head sits off-center, the glenoid rocks and loads unevenly, producing the rocking-horse loosening and eccentric wear seen in half these shoulders.
That gives you two intraoperative levers: seat and fix the glenoid on accurately prepared bone (no backside cement), and center the humeral head with soft-tissue balancing and correct component position. Design choice matters. Metal-backed and keeled glenoids failed with more loosening, malposition, dislocation, and early failure than pegged all-polyethylene designs, consistent with registry data.
When soft-tissue deficiency makes centering impossible, choose a reverse total shoulder rather than fighting an anatomic glenoid that will rock loose. One caution: this is a revision-only case series with no denominator, so it identifies associations, not true failure rates.