title: Revisions for aseptic glenoid component loosening after anatomic shoulder arthroplasty.
abstract: BACKGROUND
  Glenoid component loosening is a common indication for revision shoulder arthroplasty. The objective of this study is to assess the longer-term outcomes of patients undergoing revision specifically for aseptic loosening.
  
  
  METHODS
  Between 1985 and 2005, 34 revision shoulder arthroplasties were performed for aseptic glenoid loosening. Three patients were lost to follow-up. Treatment included component reimplantation in 20 shoulders (group I) or component removal with bone grafting in 11 shoulders (group II). We identified 9 cases of instability with or without rotator cuff tearing prior to revision. The mean follow-up period was 8.3 years.
  
  
  RESULTS
  The rate of survival free of reoperation at 10 years was 78.9% in group I and 83.9% in group II (P = .5). Pain relief occurred in 26 of 31 shoulders, with no difference between groups (P > .99). Active elevation and external rotation improved in both groups (P = .8). Five shoulders in group I had radiographically loose glenoids, with two requiring reoperation. Nine shoulders in group II had medial glenoid erosion, with two requiring reoperation for pain. There was a trend toward reoperation in those with preoperative instability (5 of 8 re-revisions).
  
  
  CONCLUSIONS
  Glenoid revision surgery in the absence of infection provides satisfactory results, especially when instability is not coexisting. When glenoid bone stock permits, reimplantation of a new glenoid component in an active patient with an intact rotator cuff and no instability is reasonable. When the remaining glenoid bone will not support a new component, conversion to a hemiarthroplasty is also reasonable.
authors.affiliation: Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN, USA.
authors.forename: William R
authors.initials: WR
authors.lastname: Aibinder
authors.affiliation: Department of Orthopedic Surgery, University of Florida, Gainesville, FL, USA.
authors.forename: Bradley
authors.initials: B
authors.lastname: Schoch
authors.affiliation: Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN, USA.
authors.forename: Cathy
authors.initials: C
authors.lastname: Schleck
authors.affiliation: Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN, USA. Electronic address: sperling.john@mayo.edu.
authors.forename: John W
authors.initials: JW
authors.lastname: Sperling
authors.affiliation: Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Cofield
mesh_terms: D000328:Adult; D000368:Aged; D000072228:Arthroplasty, Replacement, Shoulder / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000601:surgery*; D020069:Shoulder Pain / Q000601:surgery; D000072227:Shoulder Prosthesis
keywords: Glenoid; instability; loosening; revision; rotator cuff; shoulder arthroplasty