We retrospectively reviewed 32 patients who underwent glenoid
revision surgery after total shoulder
arthroplasty to compare the results of revision total shoulder
arthroplasty with those of revision
hemiarthroplasty and to identify factors associated with poor results after revision shoulder
arthroplasty for glenoid component loosening. Results were reviewed at a mean follow-up of 4 years (range, 2-8 years). Glenoid
reimplantation resulted in significant
pain relief (P < .0001), improvement in American Shoulder and Elbow Surgeons (ASES) score (P < .02), and external rotation (24 degrees to 44 degrees , P < .004). Revision to a
hemiarthroplasty also resulted in significant
pain relief (P < .01) and improvement in ASES score (P < .05). For the treatment of glenoid loosening without glenohumeral instability, both
reimplantation of a glenoid component and revision to a
hemiarthroplasty improved function, satisfaction, and level of
pain.
Reimplantation of a new glenoid component offered greater improvements in
pain (P < .008) and external rotation (increase of 20 degrees versus 3 degrees , P < .03) compared with
hemiarthroplasty. For patients with preoperative glenohumeral instability,
revision surgery did not improve motion, function, or
pain significantly. Risk factors associated with a poor outcome after revision
arthroplasty included persistent glenohumeral instability,
rotator cuff tears, and malunion of the greater tuberosity.