Osteoarthritis: Overcoming the Slippery Slope

Shoulder arthroplasty for osteoarthritis can be challenging because of eccentric posterior wear of the glenoid, glenoid retroversion, and concomitant posterior subluxation of the humeral head. Various techniques are available to restore a centered head: anterior capsulectomy, preferential anterior glenoid reaming, offset humeral head components, anteversion of the humeral component, posterior capsule plication sutures, and the use of a dual-radius glenoid prosthesis, in which the internal (articular) radius is designed to match the curvature of the humeral head prosthesis, while the external (nonarticular) radius corresponds to the overall size of the glenoid.