Christopher M Kilian1, Cyrus M Press2, Kevin M Smith3, Daniel P O'Connor4, Brent J Morris5, Hussein A Elkousy5, Gary M Gartsman5, T Bradley Edwards5. 1. Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA. Electronic address: cmk12985@gmail.com. 2. Nova Orthopaedic and Spine Care, Woodbridge, VA, USA. 3. Houston Methodist Hospital, Houston, TX, USA. 4. Health & Human Performance, University of Houston, Houston, TX, USA. 5. Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA.
Abstract
BACKGROUND: Glenoid component loosening remains a significant issue after anatomic shoulder arthroplasty. Pegged glenoid components have shown better lucency rates than keeled components in the short term; however, midterm to long-term results have not fully been determined. We previously reported early outcomes of the current randomized controlled group of patients, with higher glenoid lucency rates in those with a keeled glenoid. The purpose of this study was to evaluate the radiographic and clinical outcomes of these components at minimum 5-year follow-up. METHODS:Fifty-nine total shoulder arthroplasties were performed in patients with primary glenohumeral osteoarthritis. Patients were randomized to receive either a pegged or keeled glenoid component. Three raters graded radiographic glenoid lucencies. Clinical outcome scores and active mobility outcomes were collected preoperatively and at yearly postoperative appointments. RESULTS: Of the 46 shoulders meeting the inclusion criteria, 38 (82.6%) were available for minimum 5-year radiographic follow-up. After an average of 7.9 years, radiographic lucency was present in 100% of pegged and 91% of keeled components (P = .617). Grade 4 or 5 lucency was present in 44% of pegged and 36% of keeled components (P = .743). There were no differences in clinical outcome scores or active mobility outcomes between shoulders with pegged and keeled components at last follow-up. Within the initial cohort, 20% of the keeled shoulders (6 of 30) and 7% of the pegged shoulders (2 of 29) underwent revision surgery (P = .263). Kaplan-Meier analysis showed no significant difference in survival rates between groups (P = .560). CONCLUSION: At an average 7.9-year follow-up, non-ingrowth, all-polyethylene pegged glenoid implants are equivalent to keeled implants with respect to radiolucency, clinical outcomes, and need for revision surgery.
RCT Entities:
BACKGROUND: Glenoid component loosening remains a significant issue after anatomic shoulder arthroplasty. Pegged glenoid components have shown better lucency rates than keeled components in the short term; however, midterm to long-term results have not fully been determined. We previously reported early outcomes of the current randomized controlled group of patients, with higher glenoid lucency rates in those with a keeled glenoid. The purpose of this study was to evaluate the radiographic and clinical outcomes of these components at minimum 5-year follow-up. METHODS: Fifty-nine total shoulder arthroplasties were performed in patients with primary glenohumeral osteoarthritis. Patients were randomized to receive either a pegged or keeled glenoid component. Three raters graded radiographic glenoid lucencies. Clinical outcome scores and active mobility outcomes were collected preoperatively and at yearly postoperative appointments. RESULTS: Of the 46 shoulders meeting the inclusion criteria, 38 (82.6%) were available for minimum 5-year radiographic follow-up. After an average of 7.9 years, radiographic lucency was present in 100% of pegged and 91% of keeled components (P = .617). Grade 4 or 5 lucency was present in 44% of pegged and 36% of keeled components (P = .743). There were no differences in clinical outcome scores or active mobility outcomes between shoulders with pegged and keeled components at last follow-up. Within the initial cohort, 20% of the keeled shoulders (6 of 30) and 7% of the pegged shoulders (2 of 29) underwent revision surgery (P = .263). Kaplan-Meier analysis showed no significant difference in survival rates between groups (P = .560). CONCLUSION: At an average 7.9-year follow-up, non-ingrowth, all-polyethylene pegged glenoid implants are equivalent to keeled implants with respect to radiolucency, clinical outcomes, and need for revision surgery.
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: Bradley S Schoch; Thomas W Wright; Joseph D Zuckerman; Pierre-Henri Flurin; Charlotte Bolch; Chris P Roche; Joseph J King Journal: JSES Open Access Date: 2019-11-18