Advances in Glenoid Design in Anatomic Total Shoulder Arthroplasty

Rotator cuff imbalance, soft-tissue and capsular repair defects, and improper component sizing, positioning, and orientation can result in a high-stress environment at the periphery of the glenoid component-bone interface.

The optimal position and orientation of the glenoid for a given individual is currently unknown.

There have been advancements in glenoid design, with the advent of contemporary metal-backed and hybrid components, but their long-term efficacy has not been proven. Inset glenoid components have shown promising short- and mid-term results.

The augmented glenoid, which has shown satisfactory short-term results in the setting of posterior glenoid loss, is a potential option for glenoid bone loss that is too severe for eccentric reaming. It may be technically easier than bone-grafting, does not require union, and is not at risk of collapse or bone graft resorption.

Advances in surgical technique, including patient-specific instrumentation, may provide additional accuracy, especially in dysplastic and eccentrically worn glenoids; however, evidence for clinical benefit is still lacking.