The Orthobullets Podcast Podiums | Shoulder & Elbow | The Limits of Anatomic Shoulder Arthroplasty
Jan 3, 2026
Dr. Jay Keener, an orthopaedic shoulder specialist renowned for his skills in shoulder arthroplasty, dives deep into the intricacies of anatomic shoulder replacement. He highlights crucial decision-making factors for cuff-intact osteoarthritis and discusses the limits of glenoid correction. Keener warns about posterior subluxation risks and emphasizes the importance of rotator cuff health in surgical choices. He also challenges the reliance on MRI, advocating for clinical assessment, and explains patient factors influencing the choice between anatomic and reverse procedures.
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Make Implant Choice By Five Key Factors
- Consider glenoid deformity, rotator cuff health, subscapularis protection, stiffness, and arthritis type when choosing anatomic vs reverse arthroplasty.
- Use CT planning to guide decisions and prioritize near-complete implant seeding (95–100%).
Modern Planning Expanded But Didn’t Eliminate Limits
- CT planning and improved implant designs changed the boundaries of anatomic arthroplasty compared with older studies.
- Seeding and modern augments let you correct more deformity but each technique has clear limits.
Avoid Excessive Reaming For Version Correction
- Avoid over-reaming; don't try to correct more than ~12–15° of version with reaming alone.
- Use augments for greater retroversion but stop considering anatomic implants when retroversion exceeds ~30°.