Juan Paulo Panti1, Simon Tan2, Warren Kuo2, Sebastian Fung3, Kim Walker4, Jed Duff4. 1. St. Vincent's SportsMed, Suite 407, St. Vincent's Clinic, 438 Victoria, Darlinghurst, Sydney, NSW, 2010, Australia. docpaulopanti@gmail.com. 2. St. Vincent's SportsMed, Suite 407, St. Vincent's Clinic, 438 Victoria, Darlinghurst, Sydney, NSW, 2010, Australia. 3. St. Vincent's Medical Imaging and Nuclear Medicine, Suite 501, St. Vincent's Clinic, 438 Victoria, Darlinghurst, Sydney, NSW, 2010, Australia. 4. University of Tasmania/SVPHS, 230 Barcom Ave, Darlinghurst, Sydney, NSW, 2010, Australia.
Abstract
BACKGROUND: A porous tantalum glenoid component for total shoulder replacements was introduced in 2003 to promote biologic ingrowth. However, reports of component failure prompted design modifications. The purpose of this study is to present the largest series to date, of TSR with the second-generation Trabecular Metal™ glenoid component. METHOD: A radiologic and clinical evaluation of the second-generation TM glenoid was conducted in consecutive cases of 76 shoulders (66 patients) with a mean follow-up of 43.2 months (range 24-72 months). Pre-operative VAS score, patient self-assessed ASES score, active shoulder range of motion, and radiologic assessment were recorded. Patients were recalled for latest follow-up clinical and radiologic evaluation. RESULTS: On latest follow-up, the mean VAS scores (pre-op: 6.4-latest: 0.9) and ASES scores (pre-op: 36.9-latest: 88.5) improved. Active range of motion improved in all planes. There was no report of glenoid component migration, loosening, or humeral stem subsidence. The incidence of non-progressive radiolucency in the glenoid was 6.6 % (Franklin 1: 3 cases, Franklin 2: 2 cases). Post-operative complications involved dislocation (n = 2) which were reduced in ED, post-operative stiffness (n = 1), transient axillary nerve neuropraxia (n = 1), and supraspinatus tear which underwent arthroscopic repair at 16 months post-op. There were no revision surgeries for implant loosening nor glenoid component fracture at the peg-base plate junction. CONCLUSIONS: The modifications established in the second-generation TM glenoid resulted to improve early to mid-term survivorship and clinical outcomes in TSR, with promise of long-term implant stability through bony ingrowth. LEVEL OF EVIDENCE: Level IV, case series, treatment study.
BACKGROUND: A porous tantalum glenoid component for total shoulder replacements was introduced in 2003 to promote biologic ingrowth. However, reports of component failure prompted design modifications. The purpose of this study is to present the largest series to date, of TSR with the second-generation Trabecular Metal™ glenoid component. METHOD: A radiologic and clinical evaluation of the second-generation TM glenoid was conducted in consecutive cases of 76 shoulders (66 patients) with a mean follow-up of 43.2 months (range 24-72 months). Pre-operative VAS score, patient self-assessed ASES score, active shoulder range of motion, and radiologic assessment were recorded. Patients were recalled for latest follow-up clinical and radiologic evaluation. RESULTS: On latest follow-up, the mean VAS scores (pre-op: 6.4-latest: 0.9) and ASES scores (pre-op: 36.9-latest: 88.5) improved. Active range of motion improved in all planes. There was no report of glenoid component migration, loosening, or humeral stem subsidence. The incidence of non-progressive radiolucency in the glenoid was 6.6 % (Franklin 1: 3 cases, Franklin 2: 2 cases). Post-operative complications involved dislocation (n = 2) which were reduced in ED, post-operative stiffness (n = 1), transient axillary nerve neuropraxia (n = 1), and supraspinatus tear which underwent arthroscopic repair at 16 months post-op. There were no revision surgeries for implant loosening nor glenoid component fracture at the peg-base plate junction. CONCLUSIONS: The modifications established in the second-generation TM glenoid resulted to improve early to mid-term survivorship and clinical outcomes in TSR, with promise of long-term implant stability through bony ingrowth. LEVEL OF EVIDENCE: Level IV, case series, treatment study.