During revision total shoulder arthroplasty, bone grafting severe glenoid defects without concomitant reinsertion of a glenoid
prosthesis may be the only viable reconstructive option. However, the fate of these grafts is unknown. We questioned the durability
and subsidence of the graft and the associated clinical outcomes in patients who have this procedure. We retrospectively reviewed
11 patients with severe glenoid deficiencies from aseptic loosening of a glenoid component who underwent conversion of a total
shoulder arthroplasty to a humeral head replacement and glenoid bone grafting. Large cavitary defects were grafted with either
allograft cancellous chips or bulk structural allograft, depending on the presence or absence of glenoid vault wall defects,
without prosthetic glenoid resurfacing. Clinical outcomes (Penn Shoulder Score, maximum 100 points) improved from 23 to 57
at a minimum 2-year followup (mean, 38 months; range, 24–73 months). However, we observed substantial graft subsidence in
all patients, with eight of 11 patients having subsidence greater than 5 mm; the magnitude of graft resorption did not correlate
with clinical outcome scores. Greater subsidence was seen with structural than cancellous chip allografts. Bone grafting large
glenoid defects during revision shoulder arthroplasty can improve clinical outcome scores, but the substantial resorption
of the graft material remains a concern.
Level of Evidence: Level III Prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest,
patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations
were conducted in conformity with ethical principles of research, and that informed consent for participation in the study
was not required by our Institutional Review Board after review and approval of the protocol.