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This review article discusses the current concepts in glenoid component design for anatomic total shoulder arthroplasty (TSA), focusing on implant options like all-polyethylene, hybrid, metal-backed, augmented, and inlay designs. It examines the impact of articulation conformity, fixation methods (keeled vs. pegged), and implant characteristics on micromotion, radiolucency, and loosening. The review also touches on emerging technologies like patient-specific instrumentation and computer-assisted surgery.
Understanding the nuances of glenoid component design and fixation can help surgeons optimize implant selection and surgical technique in anatomic TSA to potentially improve patient outcomes and reduce complications.
Anatomic total shoulder arthroplasty (TSA) has advanced considerably in recent decades, with the glenoid component recognized as a pivotal determinant of patient outcomes. This review integrates current literature and biomechanical insights surrounding contemporary glenoid implant designs, including all-polyethylene, hybrid, metal-backed, augmented, and inlay options. It examines key considerations such as the balance between conforming and nonconforming articulations, differences between keeled and pegged fixation, and how implant characteristics affect micromotion, radiolucency, and loosening risks. Additionally, innovative technologies like patient-specific instrumentation, computer-assisted surgery, and artificial intelligence are discussed in relation to improving implant positioning and surgical precision. By collating available evidence and implant strategies for glenoid replacement in anatomic TSA, this article aims to assist orthopaedic surgeons in making informed, patient-specific implant choices based on individual anatomy and functional requirements.
