Options for glenoid bone loss: Composites of prosthetics and biologics

Management of glenoid bone loss in shoulder arthroplasty is challenging. Currently available prosthetic, biologic, and composite prosthetic and biologic solutions are not ideal. The most common solutions involve a combination of asymmetric reaming, bone grafting, and standard polyethylene components. The development of additional prosthetic and biologic solutions may require a change in the way glenoid bone loss and component fixation are conceptualized. Classifications should be modified to consider the portions of the glenoid still remaining for fixation. In addition, the concept of placing glenoid components in the glenoid vault rather than on the subchondral surface, which is often deficient, should be developed. These changes may result in mass-produced glenoid components that could make management of glenoid bone loss more reproducible.