Glenoid Exposure: Tricks of the Trade

Hemiarthroplasty is performed for arthritic degeneration of the glenohumeral joint about four to five times more frequently than total shoulder arthroplaty. This is in distinct contrast to all other major joints where biarticular resurfacing is the standard. Failed hemiarthroplasty due to glenoid pain is one of the more common reasons for revising such cases and performing total shoulder arthroplasty. One suspected reason for the high use of hemiarthroplasty is difficulty in gaining access to the glenoid. Good glenoid exposure is not difficult but requires careful attention to detail. The surgical approach with careful release of key soft tissue structures, removal of peripheral osteophytes on both the humeral and glenoid side, appropriate humeral head cut, and key placement of specific retractors all lead to excellent glenoid visualization and access. Key steps in gaining this access will be presented.