ArticleJSES international2026
Pre-operative glenoid bone density varies by indication for reverse shoulder arthroplasty: a comparison of glenoid bone density in proximal humerus fractures, glenohumeral osteoarthritis, and rotator cuff arthropathy.
Article in JSES international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Glenoid bone mineral density (BMD) has important implications for the fixation of glenoid components and may vary based on indications for reverse total shoulder arthroplasty (rTSA). Methods: A retrospective chart review was conducted on patients receiving an rTSA from a single surgeon from March 2021-May 2024 with one of the 3 following diagnoses: proximal humerus fracture (FX), glenohumeral osteoarthritis (GHOA), and rotator cuff arthropathy (RCA). Pre-operative computerized tomography scans were analyzed for glenoid BMD. Differences in BMDs across different shoulder pathologies were assessed with general linear regression models adjusted for age and body mass index. Results: In sum, 150 patients were identified who underwent an rTSA for one of the 3 following diagnoses: FX (n = 24, 16%), GHOA (n = 64, 43%), and RCA (n = 62, 41%). Fifty-one (34%) of patients were male and 99 (66%) of patients were female. Average subchondral BMD was 150 Hounsfield Units (HUs) (95% confidence interval of 92-207 HUs) for FX, 304 HUs (268-339 HUs) for GHOA, and 208 HUs (172-244 HUs) for RCA. Subchondral bone in patients with GHOA was significantly denser than FX and RCA ( Conclusion: This study demonstrates that subchondral glenoid BMD varies among patients undergoing rTSA depending on the underlying pathology. Fracture rTSAs have the lowest subchondral BMD when compared to GHOA and RCA patients. BMD of the anterior cortex appears equivalent despite indication for rTSA. Incorporating glenoid BMD assessments into surgical planning may enhance implant fixation and possibly avoid complications such as implant loosening. Further prospective studies are warranted to validate and refine clinical decision-making based on glenoid bone quality.
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