How to deal with posterior glenoid erosion in anatomic total shoulder arthroplasty

Posterior glenoid bone defects are a frequent clinical problem impacting the surgical technique and choice of implant in total shoulder arthroplasty (TSA). Bone grafting with autologous or allogenic bone is one option for filling the defect and correcting pathological glenoid version. The use of posteriorly augmented glenoid implants, which were mostly cemented polyethylene components, have been described in the past and have recently been expanded by the use of augmented uncemented metallic components or a combination of either implant with or without bone grafting. Bone grafting for small posterior bone defects is technically challenging and the use of augmented implants represents a promising alternative. Clinical results are generally promising but are less favorable compared to cases without glenoid bone defects. The choice of implant, surgical technique, and the way to perform bone grafting is according to the surgeon’s preference based on the patient’s individual anatomy, available implants, and personal experience.