JSES - 2026-04-01 - Journal Article
Characterizing glenoid wear after hemiarthroplasty with concentric glenoid reaming: a study of 113 arthroplasties at a mean of 6.7 years of follow-up.
Collins AP, Sheth MM, Stenson JF, Kahsai EA, Khoo KJ, Ogunleye T, Whitson AJ, Matsen FA, Hsu JE
Topics
Key Takeaway
Glenoid wear after ream-and-run arthroplasty averages 0.3 mm/year and plateaus after 4 years, with 81% of patients experiencing ≤5 mm medialization at mean 6.7-year follow-up.
Summary Depth
Choose how much analysis to show on this article page.
Summary
This study quantified glenoid medialization and its clinical impact in 113 shoulders undergoing ream-and-run arthroplasty with minimum 4-year radiographic follow-up. Wear was categorized as minimal/mild (81%), moderate (13%), or severe (5%), with a mean total medialization of 2.9 mm following a quadratic rather than linear pattern (R²=0.821), with most wear occurring in the first 4 years. Younger patients and those without prior shoulder surgery were at higher risk for moderate/severe wear, but SST and pain scores did not differ between wear cohorts despite higher open revision rates in the moderate/severe group.
Key Limitation
Revision and loss-to-follow-up bias is unquantified; patients who underwent early revision for symptomatic wear were likely excluded, artificially improving the apparent functional outcome equivalence between wear cohorts.
Original Abstract
BACKGROUND
Hemiarthroplasty with concentric glenoid reaming (ream-and-run arthroplasty) using a metal humeral head can be considered in young, active patients who want to remain active and avoid the risks and limitations associated with a prosthetic glenoid component. However, there are concerns with glenoid bone wear over time. This study sought to better characterize the amount and rate of glenoid wear and associations with glenoid wear with patient-reported outcomes.
MATERIALS AND METHODS
Patients enrolled into shoulder arthroplasty database with comparable radiographs and minimum 4-year radiographic follow-up were included. Medialization was determined by measuring the position of the humeral head center of rotation relative to a line drawn through the lateral edge of the acromion and parallel with the glenoid face. The amount of medialization was calculated between interval radiographs. Glenoid wear was categorized into minimal/mild (≤5 mm), moderate (>5 mm but below ≤10 mm), or substantial (>10 mm). Simple Shoulder Test were collected preoperatively and annually for each patient.
RESULTS
Comparable radiographs of 113 shoulders with a mean radiographic follow-up of 6.7 ± 2.3 years were analyzed. Minimal/mild glenoid wear was noted in 92 (81%) patients, moderate wear in 15 (13%), and severe wear in 6 (5%). The mean total glenoid wear was 2.9 ± 4.3 mm. Based on linear modeling, the glenoid wear rate was calculated at 0.3 mm per year, but medialization rates were best predicted by a quadratic function (R 2 = 0.821; P = .001) rather than a linear function. The majority of glenoid wear occurred in the first 4 years after ream-and-run arthroplasty and plateaued thereafter. On multivariable analysis, younger patients (P = .004) and patients without prior shoulder surgery (P = .015) were at risk for moderate or severe glenoid wear. Change in Simple Shoulder Test and pain scores were not different in those with minimal/mild wear compared to those with moderate or severe medialization, but open revision rates were higher in those with moderate or severe medialization.
CONCLUSION
Glenoid wear after hemiarthroplasty with concentric glenoid reaming using a metallic humeral head occurs at a rate of approximately 0.3 mm/year but may not be linear over time. Improvement in clinical outcomes demonstrated no differences between minimal/mild wear and moderate/severe wear cohorts.