Key result
Extensive glenoid radiolucent lines and component subsidence after anatomic total shoulder arthroplasty did not significantly impair long-term clinical or functional outcomes.
Why the study?
The impact of glenoid radiolucent lines and glenoid component subsidence on long-term clinical outcomes after anatomic total shoulder arthroplasty remains unclear.
Does the presence of glenoid radiolucent lines or subsidence impact long-term clinical and functional outcomes in patients after anatomic total shoulder arthroplasty?
Observational (n=52)
Does the presence of glenoid radiolucent lines or subsidence impact long-term clinical and functional outcomes in patients after anatomic total shoulder arthroplasty?
Glenoid radiolucent lines and subsidence do not significantly impair long-term clinical or functional outcomes after anatomic total shoulder arthroplasty in patients without revision surgery.
This is the authors' abstract. We don't add key points for this paper.
Background: Glenoid radiolucenct lines (gRLL) and glenoid component subsidence (gSC) after anatomic total shoulder arthroplasty (aTSA) have traditionally been linked to implant loosening and functional decline. However, their impact on long-term clinical outcomes remains unclear. This study aimed to evaluate whether gRLL and gSC are associated with inferior clinical or functional results in patients without revision surgery. Methods: In this retrospective study, 52 aTSA cases (2008–2015) were analyzed with a minimum of five years of clinical and radiographic follow-up. Based on final imaging, patients were categorized according to the presence and extent of gRLL and gSC. Clinical outcomes included the Constant-Murley Score, DASH, VAS for pain, and range of motion (ROM). Radiographic parameters included the critical shoulder angle (CSA), acromiohumeral distance (AHD), lateral offset (LO), humeral head-stem index (HSI), and cranial humeral head decentration (DC). Group comparisons were conducted between: (1) ≤2 vs. 3 gRLL zones, (2) 0 vs. 1 zone, (3) 0 vs. 3 zones, (4) gSC vs. no gSC, and (5) DC vs. no DC. Results: Demographics and baseline characteristics were comparable across groups. Functional scores (Constant, DASH), pain (VAS), and ROM were largely similar. Patients with extensive gRLL showed reduced external rotation (p = 0.01), but the difference remained below the MCID. Similarly, gSC was associated with lower forward elevation (p = 0.04) and external rotation (p = 0.03), both below MCID thresholds. No significant differences were observed for DC. Conclusions: Neither extensive gRLL nor gSC significantly impaired long-term clinical or functional outcomes. As these radiographic changes can occur in the absence of symptoms, regular radiographic monitoring is essential, and revision decisions should be made individually in cases of progressive bone loss.
Answers are grounded in this paper and cite their sources.
Glenoid changes after aTSA do not impair outcomes in non-revised patients; supports current practice but leaves open prospective validation.
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Hochberger et al. (2025) conducted an observational in Anatomic total shoulder arthroplasty (aTSA) (n=52). Glenoid radiolucent lines (gRLL) and glenoid component subsidence (gSC) vs. No or less extensive gRLL/gSC was evaluated on Clinical and functional outcomes (Constant-Murley Score, DASH, VAS for pain, and range of motion). Extensive glenoid radiolucent lines and component subsidence after anatomic total shoulder arthroplasty did not significantly impair long-term clinical or functional outcomes.
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