Treatment of symptomatic glenoid loosening following unconstrained shoulder arthroplasty.

Abstract

Nine patients with symptomatic glenoid loosening were identified and ultimately underwent surgical revision. Preoperative assessment demonstrated that pain, decreased range of motion, and functional disability were common features. A painful clunking sensation with forward elevation of the arm was noted in four of the nine patients. At surgical revision, a grossly loose glenoid component was found in all cases and removed. Seven of the nine patients underwent revision using another cemented glenoid component, and two patients were left with a hemiarthroplasty due to glenoid bone deficiency. Results following revision surgery demonstrated increased range of motion, decreased pain, and increased functional ability with good overall patient satisfaction in seven of nine patients. Two patients in whom revision glenoid components were implanted were considered failures due to recurrent loosening. Although revision of the glenoid component is often technically feasible, recurrent loosening may occur. Revision to a hemiarthroplasty may be an acceptable alternative to glenoid replacement.