Akin Cil1, John W Sperling2, Robert H Cofield3. 1. Department of Orthopaedics, University of Missouri, Kansas City, MO, USA. 2. Department of Orthopedic Surgery, Mayo Clinic and Mayo Foundation, Rochester, MN, USA. 3. Department of Orthopedic Surgery, Mayo Clinic and Mayo Foundation, Rochester, MN, USA. Electronic address: cofield.robert@mayo.edu.
Abstract
BACKGROUND: Glenoid bone deficiencies may be addressed by specialized components. The purpose of this study is to evaluate the clinical and radiographic outcomes of 3 different types of nonstandard glenoid components. MATERIALS AND METHODS: Thirty-eight patients with a mean age of 65 years (range, 34-84 years) underwent a primary or revision anatomic shoulder arthroplasty with one of 3 nonstandard glenoid components: a polyethylene component with an angled keel for posterior glenoid wear without posterior subluxation; a polyethylene component with 2 mm of extra thickness for central glenoid erosion; or a posteriorly augmented metal-backed glenoid component for posterior glenoid wear and posterior subluxation. Average clinical follow-up was 7.3 years (range, 2-19 years) or until revision surgery. RESULTS: At the most recent follow-up, 24 patients had no, mild, or occasionally moderate pain. Mean elevation improved from 91° to 126°, and mean external rotation improved from 24° to 53°. Thirteen patients had moderate or severe subluxation preoperatively, and 11 had subluxation at follow-up. On radiographic evaluation, 3 glenoid components had loosened and 3 were at risk for loosening at an average 5.5 years of follow-up. Seven patients had revision surgery: 4 for instability, 1 for osteolysis, 1 for component loosening with osteolysis, and 1 for a periprosthetic fracture. Three additional patients had removal of glenoid components, 2 for infection and 1 for loosening. Ten-year survival rate free of revision or removal of the angled keel component was 73% (95% CI: 75.3-70.7); of the extra thick (+2 mm) component, 69% (95% CI: 65-73); and of the posteriorly augmented metal-backed glenoid component, 31% (95% CI: 35.6-26.4). CONCLUSIONS: The effectiveness of nonstandard glenoid components in addressing glenoid bone deficiencies is compromised by an increased rate of component loosening and by only partial success in eliminating subluxation.
BACKGROUND:Glenoid bone deficiencies may be addressed by specialized components. The purpose of this study is to evaluate the clinical and radiographic outcomes of 3 different types of nonstandard glenoid components. MATERIALS AND METHODS: Thirty-eight patients with a mean age of 65 years (range, 34-84 years) underwent a primary or revision anatomic shoulder arthroplasty with one of 3 nonstandard glenoid components: a polyethylene component with an angled keel for posterior glenoid wear without posterior subluxation; a polyethylene component with 2 mm of extra thickness for central glenoid erosion; or a posteriorly augmented metal-backed glenoid component for posterior glenoid wear and posterior subluxation. Average clinical follow-up was 7.3 years (range, 2-19 years) or until revision surgery. RESULTS: At the most recent follow-up, 24 patients had no, mild, or occasionally moderate pain. Mean elevation improved from 91° to 126°, and mean external rotation improved from 24° to 53°. Thirteen patients had moderate or severe subluxation preoperatively, and 11 had subluxation at follow-up. On radiographic evaluation, 3 glenoid components had loosened and 3 were at risk for loosening at an average 5.5 years of follow-up. Seven patients had revision surgery: 4 for instability, 1 for osteolysis, 1 for component loosening with osteolysis, and 1 for a periprosthetic fracture. Three additional patients had removal of glenoid components, 2 for infection and 1 for loosening. Ten-year survival rate free of revision or removal of the angled keel component was 73% (95% CI: 75.3-70.7); of the extra thick (+2 mm) component, 69% (95% CI: 65-73); and of the posteriorly augmented metal-backed glenoid component, 31% (95% CI: 35.6-26.4). CONCLUSIONS: The effectiveness of nonstandard glenoid components in addressing glenoid bone deficiencies is compromised by an increased rate of component loosening and by only partial success in eliminating subluxation.
Authors: Tim Wang; Geoffrey D Abrams; Anthony W Behn; Derek Lindsey; Nicholas Giori; Emilie V Cheung Journal: Clin Orthop Relat Res Date: 2015-08-05 Impact factor: 4.176