Long-term follow-up of total shoulder replacement surgery with inset glenoid implants for arthritis with deficient bone

Background: Total shoulder replacement surgery has been a successful treatment for patients with shoulder arthritis. However, long-term results are limited by complications such as glenoid loosening, wear, and instability. Also, glenoid bone deficiency limits available treatment options and outcomes. Successful short-term outcomes have been reported previously using inset glenoid implants for deficient arthritic bone, but long-term outcomes have not been reported using this technique. Methods: A retrospective analysis was performed on 21 of 24 consecutive patients treated with inset glenoid implants for severe glenohumeral joint arthritis with bone deficiency with prospectively collected data. Inclusion criteria were patients with shoulder arthritis and severe glenoid bone deficiency, defined by perpendicular glenoid vault depth less than 15 mm. No bone grafts were used. All patients were evaluated preoperatively and after surgery with physical examination, radiographic studies, and outcome measures. There were 10 males and 11 females, 17 cases with osteoarthritis and 4 with inflammatory arthritis, and 5 patients with rotator cuff tears (3 full thickness and 2 partial tears). Mean age was 68 years. Results: There were no surgical complications. At a mean follow-up of 8.7 years, there were statistically significant improvements (P < .001) in visual analog pain scores (7.7 to 0.1), American Shoulder and Elbow Surgeons outcome scores (23 to 95), and range of motion. There were no loose glenoids. No patients required any revision surgery. Conclusions: This study documents the long-term efficacy and safety of total shoulder replacement surgery with inset glenoid implants used to reconstruct deficient, arthritic glenoid bone. (C) 2019 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.