Current concepts in the surgical management of primary glenohumeral arthritis with a biconcave glenoid

Glenoid morphology has an important impact on outcomes and complication rates after shoulder arthroplasty for primary glenohumeral arthritis. The B2 glenoid, or a biconcave glenoid with posterior humeral head subluxation, in particular has been associated with a poorer outcome with shoulder arthroplasty compared with other glenoid types. A variety of techniques may be used to address the bone deficiency and instability seen with this glenoid type. Studies suggest that total shoulder arthroplasty may have a reasonable result in the short term but be associated with a high complication rate in the mid term because of recurrence of instability and early glenoid loosening when neoglenoid retroversion is greater than 27 degrees or posterior humeral head subluxation is greater than 80%. Particularly in older patients with a substantial B2 deformity, primary reverse shoulder arthroplasty may be a more predictable means of addressing bone deficiency and restoring stability. (C) 2013 Journal of Shoulder and Elbow Surgery Board of Trustees.