Glenoid revision surgery after total shoulder arthroplasty

Forty-eight shoulders that underwent glenoid component revision surgery wer e reviewed at a mean of 4.9 years (range, 2 to 12 years). The indications f or surgery were glenoid component loosening in 29 shoulders, glenoid implan t failure in 14 shoulders, and glenoid component malposition or wear leadin g to instability in 5 shoulders. Seventeen shoulders had associated instabi lity. Thirty shoulders underwent implantation of a new glenoid component an d 18 underwent removal of the component and bone grafting for bone deficien cies. There was significant pain relief, improvement in active elevation an d external rotation, and satisfaction with revision glenoid surgery (P < .0 5). Patients without a glenoid component were significantly less satisfied with the procedure than those patients who underwent reimplantation of a gl enoid component (P = .07). Satisfactory pain relief was achieved in 86% of patients with a new glenoid component and 66% of patients who underwent gle noid component removal. Seven shoulders with a new glenoid component (2 for glenoid loosening) and 5 who underwent removal without reimplantation (3 f or painful glenoid arthritis) required re-revision surgery. Eleven of the 1 7 patients with instability were stable at the most recent follow-up. The d ata from this study suggest that at the time of revision glenoid surgery, p atients who have placement of a glenoid component have a higher degree of s atisfaction than chose undergoing glenoid component removal. Patients who c ontinue to have pain after bone grafting without placement of a component m ay be candidates for glenoid component placement after graft consolidation.