Treatment of glenoid loosening and bone loss due to osteolysis with glenoid bone grafting

Twenty-four patients underwent conversion of a total shoulder replacement to a humeral head replacement with glenoid bone grafting for glenoid loosening due to osteolysis. Of the 24 patients, 18 (75%) had satisfactory pain relief at a mean follow-up of 33.4 months (range, 24-63 months). Four had good pain relief with conversion back to total shoulder replacement at a mean of 11 months (range, 9-15 months) after the index procedure, thus bringing the rate of overall satisfactory pain relief to 92%. Two patients continued to report significant pain and were not satisfied with the procedure. Significant functional motion improvements were not seen (P > .05). Graft subsidence was seen in 10 of 20 cases (50%). Bone grafting of glenoid defects in revision arthroplasty provides satisfactory improvement in terms of pain relief and, by improving bone stock, allows for placement of a glenoid component at a later date if there is persistent pain. However, high rates of graft subsidence are concerning.