Asymmetric reaming compared to posterior augmented components for posterior glenoid wear and retroversion in anatomic total shoulder arthroplasty: a minimum ten-year follow-up outcome analysis
- 1Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA
Abstract
Background: Posterior glenoid wear with posterior humeral subluxation can be challenging in total shoulder arthroplasty (TSA). Traditionally asymmetric reaming (AR) was used to correct glenoid retroversion. Issues included joint medialization, loss of bony support, and implant subsidence in cases of biconcavity. Augmented glenoid components have been shown to restore glenoid version while minimizing medialization. The purpose of this study was to compare long-term clinical and radiographic outcomes in patients who underwent AR versus augmented components for retroverted glenoid correction in the setting of an anatomic TSA.
Methods: This was a follow-up study of our previous retrospective series. Between 2007 and 2012, 97 patients with posterior glenoid wear and a minimum of 15 degrees of retroversion were treated with either asymmetric anterior glenoid reaming (AR group, n = 49) or with a posteriorly augmented glenoid component (PAG group, n = 43). Pre-operative retroversion was recorded on axillary radiographs. Our primary outcome was pain and function assessed with the American Shoulder and Elbow Surgeons score at final follow-up. Secondary outcomes included, the Single Assessment Numerical Evaluation, visual analog scale pain score, complications, and radiographic outcomes.
Results: Twenty-eight patients were lost to follow-up. Sixty-nine patients comprising 36 who underwent AR and 33 who underwent posterior augmentation were included. Twenty-four patients (35%) were female. The mean age and body mass index of the cohort were 64.9 ± 8.1 years and 29.6 ± 5.4 kg/m2. The mean follow-up for clinical outcomes was 13.8 ± 1.5 years. Pre-operative glenoid deformity characterized by the Walch classification demonstrated that the AR group had statistically significantly less retroversion and less posterior subluxation than the PAG group. Radiographic outcomes had a mean follow-up of 5 years. Post-operative American Shoulder and Elbow Surgeons, Single Assessment Numerical Evaluation, and visual analog scale scores were not significantly different between groups (P > .05). Three patients underwent revision surgery, all of whom were in the AR group (8.3% vs. 0%, P = .24). The mean time to revision was 9.6 years. The mean reaming depth was significantly higher in the AR group compared to the posterior augmentation group (3.2 ± 0.4 mm vs. 2.1 ± 0.5, P < .001). Final post-operative retroversion (18.0° ± 8.0] vs. 16.9° ± 9.1], P = .58) and humeral head subluxation (64.5 mm ± 14.1 vs. 65.4 ± 9.5, P = .78) were similar. Finally, the rate of post-operative central and peripheral peg breach was similar between groups.
Conclusion: TSA utilizing partial correction with AR or PAG components are both acceptable options addressing shoulder arthritis and glenoid deformity. Improved clinical outcomes following AR are maintained in the long term with comparable survivability to patients treated with augmented glenoid components.
Related
- Posterior Osteophyte Resection from the Medial Femoral Condyle Increases Medial Gap of Extension and Mid-Flexion in Total Knee Arthroplasty
- Use of a high-speed pencil-tip burr for removal of well-fixed humeral components in revision shoulder arthroplasty
- Smartwatch-based pelvic tracking system for augmented reality navigation in total hip arthroplasty: a preliminary clinical study.
- Comparable clinical outcomes but different postoperative Dynamic Alignment of the Knee (DyAK) patterns between cruciate-retaining and posterior-stabilized inserts in functionally aligned robotic-assisted total knee arthroplasty.
- Asymmetric cement distribution in the coronal plane increases the risk of prosthetic loosening following total knee arthroplasty: an in-silico study.
BibTeX
@article{sogbein2026asymmetric,
title = {{Asymmetric reaming compared to posterior augmented components for posterior glenoid wear and retroversion in anatomic total shoulder arthroplasty: a minimum ten-year follow-up outcome analysis}},
author = {Olawale A. Sogbein and Miguel Fiandeiro and Adam A. Rizk and Harrison S. Fellheimer and Pranav Jain and Adam Z. Khan and Gerald R. Williams and Charles L. Getz},
journal = {Journal of shoulder and elbow arthroplasty},
year = {2026},
month = sep,
doi = {10.1016/j.jsea.2026.100100},
url = {https://europepmc.org/article/PMC/PMC13722544},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Asymmetric reaming compared to posterior augmented components for posterior glenoid wear and retroversion in anatomic total shoulder arthroplasty: a minimum ten-year follow-up outcome analysis
AU - Olawale A. Sogbein
AU - Miguel Fiandeiro
AU - Adam A. Rizk
AU - Harrison S. Fellheimer
AU - Pranav Jain
AU - Adam Z. Khan
AU - Gerald R. Williams
AU - Charles L. Getz
PY - 2026
DA - 2026/09/29
JO - Journal of shoulder and elbow arthroplasty
DO - 10.1016/j.jsea.2026.100100
UR - https://europepmc.org/article/PMC/PMC13722544
AB - Background: Posterior glenoid wear with posterior humeral subluxation can be challenging in total shoulder arthroplasty (TSA). Traditionally asymmetric reaming (AR) was used to correct glenoid retroversion. Issues included joint medialization, loss of bony support, and implant subsidence in cases of biconcavity. Augmented glenoid components have been shown to restore glenoid version while minimizing medialization. The purpose of this study was to compare long-term clinical and radiographic outcomes in patients who underwent AR versus augmented components for retroverted glenoid correction in the setting of an anatomic TSA. Methods: This was a follow-up study of our previous retrospective series. Between 2007 and 2012, 97 patients with posterior glenoid wear and a minimum of 15 degrees of retroversion were treated with either asymmetric anterior glenoid reaming (AR group, n = 49) or with a posteriorly augmented glenoid component (PAG group, n = 43). Pre-operative retroversion was recorded on axillary radiographs. Our primary outcome was pain and function assessed with the American Shoulder and Elbow Surgeons score at final follow-up. Secondary outcomes included, the Single Assessment Numerical Evaluation, visual analog scale pain score, complications, and radiographic outcomes. Results: Twenty-eight patients were lost to follow-up. Sixty-nine patients comprising 36 who underwent AR and 33 who underwent posterior augmentation were included. Twenty-four patients (35%) were female. The mean age and body mass index of the cohort were 64.9 ± 8.1 years and 29.6 ± 5.4 kg/m2. The mean follow-up for clinical outcomes was 13.8 ± 1.5 years. Pre-operative glenoid deformity characterized by the Walch classification demonstrated that the AR group had statistically significantly less retroversion and less posterior subluxation than the PAG group. Radiographic outcomes had a mean follow-up of 5 years. Post-operative American Shoulder and Elbow Surgeons, Single Assessment Numerical Evaluation, and visual analog scale scores were not significantly different between groups (P > .05). Three patients underwent revision surgery, all of whom were in the AR group (8.3% vs. 0%, P = .24). The mean time to revision was 9.6 years. The mean reaming depth was significantly higher in the AR group compared to the posterior augmentation group (3.2 ± 0.4 mm vs. 2.1 ± 0.5, P < .001). Final post-operative retroversion (18.0° ± 8.0] vs. 16.9° ± 9.1], P = .58) and humeral head subluxation (64.5 mm ± 14.1 vs. 65.4 ± 9.5, P = .78) were similar. Finally, the rate of post-operative central and peripheral peg breach was similar between groups. Conclusion: TSA utilizing partial correction with AR or PAG components are both acceptable options addressing shoulder arthritis and glenoid deformity. Improved clinical outcomes following AR are maintained in the long term with comparable survivability to patients treated with augmented glenoid components.
SN - 2471-5492
ER -