Dealing with Posterior Glenoid Wear: A Slippery Slope

Posterior glenoid bone deficiency is frequently encountered among patients undergoing total shoulder arthroplasty. In the majority of cases, posterior wear is managed by maximizing exposure to the glenoid. Other methods such as eccentric reaming or removal of anterior bone with a burr, can change the version enough to allow glenoid component implantation. Occasionally, bone grafting procedures are necessary. Excessive posterior wear can lead to severe retroversion of the implanted glenoid component and possibly subsequent postoperative instability and early loosening. Anteversion of the humeral component to compensate for excessive posterior wear is controversial, but may have some applicability in certain cases.