Background: Glenoid component loosening has been a leading cause of
failure of total shoulder arthroplasty. In the present study, we evaluated the
outcome of reimplantation of a new glenoid component following removal of the
previous glenoid component and placement of an allograft in order to determine
the results, risk factors for an unsatisfactory outcome, and rate of failure
associated with this procedure.
Methods: We reviewed the data on seven shoulders in seven patients.
At the time of glenoid component reimplantation, two shoulders received a
cemented all-polyethylene glenoid component, three received a bone-ingrowth
metal-backed component with columns and screws, and two received a
bone-ingrowth metal-backed component with columns and screws augmented with
bone cement. The average duration of follow-up was seventy-nine months. At the
time of the latest follow-up, all patients were evaluated clinically and
radiographically, patient satisfaction was assessed, and the result was graded
according to a modified Neer rating system.
Results: Two patients had positive growth of Propionibacterium
acnes on culture of intraoperative specimens obtained at the time of
revision surgery and had continuing pain, and both underwent repeat revision.
The remaining five patients expressed satisfaction with the procedure and
stated that they felt better following surgery. The mean preoperative pain
score for these five patients (on a scale from 1 to 5) was 4.6, and the mean
postoperative pain score was 2.4 (p = 0.0042). Range of motion, however, did
not improve. The Neer rating of the result (determined for the five patients
who did not undergo repeat revision) was excellent for one patient,
satisfactory for one, and unsatisfactory (because of limitation of motion) for
Conclusions: Reimplantation of a glenoid component into a previously
grafted bed can provide pain relief for most patients, but motion cannot be
Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.