Christopher M Kilian1, Brent J Morris2, Kyle R Sochacki3, Mufaddal M Gombera2, Richard E Haigler4, Daniel P O'Connor5, T Bradley Edwards2. 1. Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA. Electronic address: cmk12985@gmail.com. 2. Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA. 3. Houston Methodist Hospital, Houston, TX, USA. 4. Novant Health Orthopedics and Sports Medicine, Clemmons, NC, USA. 5. Health and Human Performance, University of Houston, Houston, TX, USA.
Abstract
BACKGROUND:Radiographic lucency of the glenoid component remains a problem after cement fixation in primary total shoulder arthroplasty. Glenoid component design likely contributes to rates of glenoid lucency. The purpose of this study was to prospectively compare radiographic lucency between a finned, cementless central pegged glenoid component (CL component) and a conventional cemented pegged glenoid component (P component) on immediate postoperative and minimum 2-year follow-up radiographs. METHODS:Fifty-four patients undergoing total shoulder arthroplasty were prospectively randomized to receive an all-polyethylene CL component or a conventional all-polyethylene P component. Three raters graded glenoid lucency and bone interdigitation on immediate postoperative and latest follow-up radiographs. Patients who had undergone revision surgery or had died before evaluation were excluded. Minimum 2-year follow-up was required for inclusion of radiographic evaluation. RESULTS:Fifty patients met inclusion criteria; 42 patients (84%; 20 CL and 22 P) were available for follow-up with the original glenoid implant in place. The mean follow-up duration was 35 months (24-64 months). There were no significant differences in glenoid radiolucency between CL (1/20 [5%]) and P (2/22 [9%]) components at last follow-up (P = .999). Five patients (25%) in the CL group had bone interdigitation. No instances of aseptic glenoid loosening occurred. CONCLUSION: There were no significant differences in the rate of glenoid lucency between the 2 groups at immediate or an average 35-month follow-up. Both techniques appear to be viable options for initial glenoid component fixation, with CL components allowing possible osseointegration, imparting potential long-term stability.
RCT Entities:
BACKGROUND: Radiographic lucency of the glenoid component remains a problem after cement fixation in primary total shoulder arthroplasty. Glenoid component design likely contributes to rates of glenoid lucency. The purpose of this study was to prospectively compare radiographic lucency between a finned, cementless central pegged glenoid component (CL component) and a conventional cemented pegged glenoid component (P component) on immediate postoperative and minimum 2-year follow-up radiographs. METHODS: Fifty-four patients undergoing total shoulder arthroplasty were prospectively randomized to receive an all-polyethylene CL component or a conventional all-polyethylene P component. Three raters graded glenoid lucency and bone interdigitation on immediate postoperative and latest follow-up radiographs. Patients who had undergone revision surgery or had died before evaluation were excluded. Minimum 2-year follow-up was required for inclusion of radiographic evaluation. RESULTS: Fifty patients met inclusion criteria; 42 patients (84%; 20 CL and 22 P) were available for follow-up with the original glenoid implant in place. The mean follow-up duration was 35 months (24-64 months). There were no significant differences in glenoid radiolucency between CL (1/20 [5%]) and P (2/22 [9%]) components at last follow-up (P = .999). Five patients (25%) in the CL group had bone interdigitation. No instances of aseptic glenoid loosening occurred. CONCLUSION: There were no significant differences in the rate of glenoid lucency between the 2 groups at immediate or an average 35-month follow-up. Both techniques appear to be viable options for initial glenoid component fixation, with CL components allowing possible osseointegration, imparting potential long-term stability.
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