Glenoid implant loose, poor bone, defect

Displaced glenoid fractures may be associated with:

• A previously loose glenoid implant
• Loosening of a previously secure glenoid implant

The bone stock of the glenoid and neck of scapula is limited. Options for revision and fracture fixation may therefore be restricted.

A direct impact to the shoulder can cause a displaced fracture of the glenoid rim or neck of the scapula, particularly in bone weakened by:

• Osteolysis due to polyethylene wear
• Osteolysis due to metallosis
• Previous poor bone quality
• Weakening of the scapular bone, eg, notching of the inferior and lateral border of the scapula neck
• Weakening of the glenoid bone, eg, contained or non-contained glenoid wall defects

• Pain
• Decreased range of motion
• Weakness in the shoulder
• Symptoms may not resolve with union of the fracture
• Dislocation of the prosthesis may occur
• The patient may be asymptomatic

• Standard trauma x-rays
• A CT scan is recommended to evaluate the fracture and remaining glenoid bone stock in more detail and to plan reconstruction
• 3D rendering may be helpful for assessment