This article points to the scarcity of data on the different factors potentially influencing the risk of glenoid component failure, one of the most important causes of unsatisfactory results from a total shoulder arthroplasty. They reviewed concepts in glenoid component design, metal glenoid components, polyethylene glenoid components, pegs vs keels, glenohumeral component mismatch, glenoid version and bone stock and observed the lack of high quality evidence supporting any particular approach to prosthetic glenoid resurfacing. They also pointed to the potentially serious problems of glenoid bone deficiency after glenoid component failure making revision difficult and less satisfactory than primary arthroplasty.
Hopefully the future will see higher quality studies that can inform better surgical techniques and component designs.
It is of interest that the figure below showing to radiographs of the same shoulder only 6 months apart is reminiscent of the problem of secondary cuff dysfunction discussed in a previous post.
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