Ideal management of the glenoid in anatomic shoulder arthroplasty remains controversial. Glenoid component loosening remains a common source of clinical concern and, in young, active patients, implantation of a glenoid prosthesis is often avoided. Efforts to decrease glenoid loosening have resulted in changes to prosthetic design and implantation techniques. Currently, a wide variety of glenoid component options are available, including metal-backed or all-polyethylene, bone ingrowth or ongrowth, inset, and augmented designs. Additionally, several alternatives are available for the young, active patient, including hemiarthroplasty, nonprosthetic resurfacing, and tissue interposition. Many recent clinical and biomechanical studies have examined these implant options. A thorough knowledge of glenoid anatomy, pathology, implant options, indications, and principles of implantation is necessary to optimize the outcome following anatomic shoulder arthroplasty.

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