Total shoulder arthroplasty: Glenoid component design

Although Charles Neer's original glenoid component underwent several modifications, the all-polyethylene, keeled component with a radius of curvature that conformed to the humeral radius of curvature and that was implanted with cement became the glenoid implant of choice. Neer reported approximately a 30% incidence of radiolucent lines; however, only 2 of 615 glenoids were revised for loosening. Other surgeons have reported radiolucent lines in up to 90% of glenoid components and have correlated symptoms with increasing radiolucencies. This has led to the development of alternative glenoid components for unconstrained total shoulder arthroplasty. Variations in component design include component shape, articular conformity, method of fixation, and material composition. The purposes of this presentation are to review the performance of the original Neer design, as well as other more recent glenoid designs, to identify factors that may influence the performance of glenoid components, and to provide a rationale for future changes in glenoid component design.