Glenoid Component Design and Fixation in Total Shoulder Arthroplasty

Glenoid component loosening is one of the most common complications of total shoulder arthroplasty. It accounts for poor functional outcome, persistent pain, and increased chance of reoperation. Many factors contribute to this phenomenon, including limited glenoid bone, especially in the setting of erosion characteristic of osteoarthritis and inflammatory arthropathies, and joint-reactive forces inherent to the shoulder joint. A great deal of research has been done in the areas of component design and implantation technique. We advocate careful glenoid preparation and pressurized cementing technique of all-polyethylene pegged or keeled glenoid components with specialized instrumentation in the majority of cases. We have narrower indications for newer, ingrowth tantalum components.