Anastasios Papadonikolakis1, Moni Blazej Neradilek2, Frederick A Matsen1. 1. Department of Orthopedics and Sports Medicine, University of Washington Medical Center, Box 356500, 1959 N.E. Pacific Street, Seattle, WA 98195. E-mail address for A. Papadonikolakis: apapadon@u.washington.edu. E-mail address for F.A. Matsen III: matsen@u.washington.edu. 2. The Mountain-Whisper-Light Statistics, 1827 23rd Avenue East, Seattle, WA 98112. E-mail address: moni@mwlight.com.
Abstract
BACKGROUND: Although glenoid component failure is one of the most common complications of anatomic total shoulder arthroplasty, substantial evidence from the recent published literature is lacking regarding the temporal trend in the rate of this complication and the risk factors for its occurrence. METHODS: We conducted a systematic review and identified twenty-seven articles presenting data on glenoid component failure rates that met the inclusion criteria. These articles represented data from 3853 total shoulder arthroplasties performed from 1976 to 2007. RESULTS: Asymptomatic radiolucent lines occurred at a rate of 7.3% per year after the primary shoulder replacement. Symptomatic glenoid loosening occurred at 1.2% per year, and surgical revision occurred at 0.8% per year. There was no significant evidence that the rate of symptomatic loosening has diminished over time. Keeled components had greater rates of asymptomatic radiolucent lines compared with pegged components in side-by-side comparison studies. However, as a result of wide variability in outcomes reporting, only sex, Walch class, and diagnosis were significantly associated with the risk of glenoid component failure in the overall analysis. CONCLUSIONS: This is the first systematic review of the published evidence on glenoid component failure. Although the authors of individual articles proposed various risk factors for glenoid component failure, many of these relationships were not significant in the present study. A consistent methodological approach to future investigations is likely to improve the quality of the evidence on which patients, techniques, and prostheses are selected for total shoulder arthroplasty.
BACKGROUND: Although glenoid component failure is one of the most common complications of anatomic total shoulder arthroplasty, substantial evidence from the recent published literature is lacking regarding the temporal trend in the rate of this complication and the risk factors for its occurrence. METHODS: We conducted a systematic review and identified twenty-seven articles presenting data on glenoid component failure rates that met the inclusion criteria. These articles represented data from 3853 total shoulder arthroplasties performed from 1976 to 2007. RESULTS: Asymptomatic radiolucent lines occurred at a rate of 7.3% per year after the primary shoulder replacement. Symptomatic glenoid loosening occurred at 1.2% per year, and surgical revision occurred at 0.8% per year. There was no significant evidence that the rate of symptomatic loosening has diminished over time. Keeled components had greater rates of asymptomatic radiolucent lines compared with pegged components in side-by-side comparison studies. However, as a result of wide variability in outcomes reporting, only sex, Walch class, and diagnosis were significantly associated with the risk of glenoid component failure in the overall analysis. CONCLUSIONS: This is the first systematic review of the published evidence on glenoid component failure. Although the authors of individual articles proposed various risk factors for glenoid component failure, many of these relationships were not significant in the present study. A consistent methodological approach to future investigations is likely to improve the quality of the evidence on which patients, techniques, and prostheses are selected for total shoulder arthroplasty.
Authors: Frederick A Matsen; Joseph P Iannotti; R Sean Churchill; Lieven De Wilde; T Bradley Edwards; Matthew C Evans; Edward V Fehringer; Gordon I Groh; James D Kelly; Christopher M Kilian; Giovanni Merolla; Tom R Norris; Giuseppe Porcellini; Edwin E Spencer; Anne Vidil; Michael A Wirth; Stacy M Russ; Moni Neradilek; Jeremy S Somerson Journal: Int Orthop Date: 2018-12-03 Impact factor: 3.075
Authors: Gregory L Cvetanovich; Peter N Chalmers; Jonathan J Streit; Anthony A Romeo; Gregory P Nicholson Journal: Clin Orthop Relat Res Date: 2015-06-12 Impact factor: 4.176
Authors: Lawrence V Gulotta; K Lauchlan Chambers; Russell F Warren; David M Dines; Edward V Craig Journal: Clin Orthop Relat Res Date: 2015-09-09 Impact factor: 4.176
Authors: Giovanni Merolla; Giovanni Ciaramella; Elisabetta Fabbri; Gilles Walch; Paolo Paladini; Giuseppe Porcellini Journal: Int Orthop Date: 2016-08-10 Impact factor: 3.075