Ream and run - will the glenoid wear away without a plastic glenoid component?

It is recognized that the polyethylene of glenoid components wears with time. We're often asked if the reamed glenoid bone will wear away after a ream and run. The question presumably comes up because of the thought that covering the glenoid with a plastic component or some other form of interposition is necessary to prevent wearing away of the underlying bone.

The answer is that we do not yet have decades of followup to definitively answer the question of glenoid wear. We have, however, published one study that does address the question.

We are now seeing what appears to be very durable results at 4 to 5 years with no evidence that the glenoid is 'at risk' for wear.

Here are the preoperative x-rays of an active man who had his bilateral ream and run surgeries five years ago.

And are his five year followup films showing a stable bone structure supporting his glenoid joint surface, particularly evident on the axillary views. There is no evidence of wear.

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