Glenoid Resurfacing in Shoulder Arthroplasty: Pro’s and Con’s

Summary

This paper compares the results of hemiarthroplasty and total arthroplasty in the different aetiology. In fracture and stages III and IV avascular necrosis, a hemi-arthroplasty seems to be sufficient, while in stage V AVN, a total shoulder is preferred. In osteoarthritis with massive cuff tear and superior translation of the head, early loosening of the glenoid has been described due to the “rocking horse phenomenon”. In our series 6 patients received a glenoid and 15 did not. We found no significant difference in the results at a follow-up of less than 2 years. However, taking into account the results in the literature, it seems preferable to perform a hemi-arthroplasty. In posttraumatic and primary osteoarthritis there is no definite answer. With glenoid resurfacing there is a better result in terms of pain relief (also found in our series) and no risk of long-term glenoid cartilage wear. The arguments against resurfacing the glenoid are the increase in operating time and the risks of component loosening. Although a hemi-arthroplasty can be inserted when there is a concave wear of the glenoid, it is better to resurface the glenoid when the wear is asymetrical or when the glenoid has a biconcave surface. In rheumatoid arthritis, the results for pain and mobility were better in our series, as in the literature, with a total arthroplasty. A total shoulder arthroplasty is recommended except where supero-medial erosion would compromise the positioning and stability of the glenoid component.