The possibility of reverse shoulder arthroplasty in case of glenoid bone loss

During the preoperative planning of shoulder arthroplasty, the surgeon encounters bone defects of the glenoid in more than 39 % of cases. Ignoring the bone defect of the glenoid leads to the malposition of the glenoidal component of the endoprosthesis, scapular notching, excessive medialization of the center of rotation, which in turn can reduce the strength and leverage of the deltoid muscle. Accurate diagnosis, assessment and selection of the optimal method of bone defect replacement are necessary for the proper functioning of the endoprosthesis and the duration of its service life.

Aim of the study was to review the literature data over the past 10 years on reverse shoulder replacement in patients with glenoid bone defects, to consider diagnostic methods, indications, advantages and disadvantages, as well as complications with various methods of restoration of glenoid bone defects.

Material and methods. The search for publications from 2014 to 2024 was carried out in databases PubMed, ResearchGate, ScienceDirect upon request: (“glenoid bone loss” OR “glenoid bone deficiency”) and “shoulder arthroplasty”.

Results and discussion. The gold standard and mandatory method should be computed tomography examination, which is necessary for three­plane evaluation of the glenoid defect and component positioning planning. The review presents various classifications, however, an universal classification that not only describes the configuration and degree of the defect, but is also directly related to treatment tactics has not been developed at the moment. Various types of defect replacement are considered. The indications, limitations and disadvantages of each method are systematized in the table.

Conclusions. Nowadays, the world literature lacks not only large­scale long­term observations and meta­analyses on reverse shoulder arthroplasty for glenoid bone defects, but also comparative studies of different types of treatment for comparable groups, which emphasizes the relevance of conducting new research in this area.

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