Analysis of Intermediate Outcomes of Glenoid Bone Grafting in Revision Shoulder Arthroplasty

Failed total shoulder arthroplasty (TSA) with glenoid bone defect is a difficult clinical problem. Large bone defects may preclude inserting a new glenoid component and require conversion to hemiarthroplasty with glenoid bone grafting. Although previously published data showed modest functional improvement in patients who underwent such treatment, outcomes might have been better if rotator cuffs were intact.

We retrospectively reviewed the clinical outcomes of 14 shoulders (13 patients) with failed TSA associated with moderate or severe glenoid defects, but with intact rotator cuff tendons. Outcomes at a mean (SD) of 44 (23) months after conversion to hemiarthroplasty with glenoid bone grafting were assessed with visual analog scale (VAS) pain score and American Shoulder and Elbow Surgeons (ASES) outcome score.

From before surgery to latest follow-up, mean (SD) VAS pain score decreased from 6.4 (1.2) to 1.6 (1.3), and mean (SD) ASES outcome score improved from 33 (11) to 72 (12). These changes were statistically significant (P < .001, Student t test). All patients demonstrated graft incorporation, and there was 1 complication (postoperative infection). For patients with failed TSA with glenoid bone defect and intact rotator cuff tendons, good functional outcomes may be obtained with conversion to hemiarthroplasty with glenoid bone grafting.