LAUSR

BACKGROUND In cases of severe osteoarthritis, posterior glenoid wear leads to acquired retroversion of the glenoid. Surgical treatment of glenoids with acquired retroversion and posterior humeral subluxation with anatomic total shoulder arthroplasty (aTSA) is controversial. The purpose of this study was to determine mid-to-long term outcomes and reoperation rates of augmented and non-augmented aTSA for treatment of glenohumeral osteoarthritis with Walch B3 glenoid deformity. METHODS This observational cohort study reviewed patients with a Walch B3 glenoid undergoing aTSA at a single institution between 2007 and 2014. Patients were contacted to complete updated patient-reported outcome measures at a minimum of 6 years postoperatively. Outcome measures collected included the American Shoulder and Elbow Surgeons (ASES) score and Single Alpha Numeric Evaluation (SANE) score. Secondary outcomes included any additional surgery on the operative shoulder, patient satisfaction, and willingness to undergo aTSA again. RESULTS Thirty-nine patients met inclusion criteria, and thirty-five (89.7%) were able to be contacted for final outcomes evaluation. Mean follow-up was 8.7 years (range 6 to 13) after surgery. Sixteen patients were treated with an augmented glenoid component, and 19 patients were treated with a standard glenoid component. Of those with standard components, all were partially corrected with asymmetric reaming. At final follow-up there were no statistically significant differences between those with augmented and standard glenoid components for mean ASES score (93.3 vs 85.7, p=.217), ASES pain score (47.2 vs 41.6, p=.161), SANE score (87.8 vs 86.0, p=.692), and percent patient satisfaction (95.6% vs 96.8%, p=.735), forward elevation (148˚ vs 149˚, p=.852), or external rotation (36˚ vs 39˚, p=.202). No patient in either group had undergone revision surgery of the operative shoulder over the study period and all patients would want to undergo the same surgery again. DISCUSSION Both augmented and standard anatomic TSA can provide satisfactory and sustained improvements in patient-reported outcomes in patients with acquired glenoid retroversion due to glenohumeral osteoarthritis. Despite a trend towards alternative treatment options, anatomic shoulder arthroplasty should remain a surgical consideration even in the setting of a Walch B3 glenoid deformity.