Daoud Makki1, Basel Balbisi2, Mohammed S Arshad3, Puneet Monga4, Steven Bale5, Ian Trail5, Michael Walton6. 1. St Helens and Knowsley University Hospitals, Prescot, UK. 2. Trauma and Orthopaedics, West Hertfordshire Hospitals NHS Trust, Watford, UK. 3. Trauma & Orhopaedics, Salford Royal NHS Foundation Trust, Wrightington Hospital, Wigan, UK. 4. Upper Limb Unit, Wrightington Hospital, Wigan, UK. 5. Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK. 6. Trauma and Orthopaedics, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK.
Abstract
Aims: Achieving purchase in native glenoid bone is essential for the stability of the glenoid baseplate when bone graft is used to address bone loss in both primary and revision shoulder arthroplasty procedures. The aim of this study is to assess the required depth of the baseplate peg in native bone when bone graft is used to result in satisfactory integration. Patients and methods: The CT scans of patients who underwent either primary or revision arthroplasty procedures with bone graft using the SMR Axioma Trabecular Titanium (TT) Metal Backed glenoid system were assessed. We measured the depth of the glenoid peg in native glenoid bone. Measurements were taken by two authors separately. Results: The scans of 53 patients (mean age 68 years) with a minimum follow-up of two years were reviewed. Implants included 12 anatomical and 41 reverse geometry prostheses. There were 17 primaries and 36 revisions: hemiarthroplasties (20) total (14) and reverse (2) implants. Bone grafts were from humeral head (15), iliac crest (34) and allograft (4). The mean depths were 8.8 mm (first assessor) and 9.10 mm (second assessor). The glenoid peg violated the glenoid vault in 32 patients and this did not adversely affect the outcome. There were three failures of implants all of which were aseptic failures and had peg penetration of less than 6 mm. Conclusions: The mean depth of glenoid peg in native bone was 9 mm (variation between 0.2 and 0.52 mm at 95% confidence interval). Aseptic loosening was seen with peg penetration less than 6 mm in native bone. Glenoid vault violation was not associated with loosening.
Aims: Achieving purchase in native glenoid bone is essential for the stability of the glenoid baseplate when bone graft is used to address bone loss in both primary and revision shoulder arthroplasty procedures. The aim of this study is to assess the required depth of the baseplate peg in native bone when bone graft is used to result in satisfactory integration. Patients and methods: The CT scans of patients who underwent either primary or revision arthroplasty procedures with bone graft using the SMR Axioma Trabecular Titanium (TT) Metal Backed glenoid system were assessed. We measured the depth of the glenoid peg in native glenoid bone. Measurements were taken by two authors separately. Results: The scans of 53 patients (mean age 68 years) with a minimum follow-up of two years were reviewed. Implants included 12 anatomical and 41 reverse geometry prostheses. There were 17 primaries and 36 revisions: hemiarthroplasties (20) total (14) and reverse (2) implants. Bone grafts were from humeral head (15), iliac crest (34) and allograft (4). The mean depths were 8.8 mm (first assessor) and 9.10 mm (second assessor). The glenoid peg violated the glenoid vault in 32 patients and this did not adversely affect the outcome. There were three failures of implants all of which were aseptic failures and had peg penetration of less than 6 mm. Conclusions: The mean depth of glenoid peg in native bone was 9 mm (variation between 0.2 and 0.52 mm at 95% confidence interval). Aseptic loosening was seen with peg penetration less than 6 mm in native bone. Glenoid vault violation was not associated with loosening.
Authors: M Königshausen; B Jettkant; N Sverdlova; C Ehlert; J Gessmann; T A Schildhauer; D Seybold Journal: Technol Health Care Date: 2015 Impact factor: 1.285
Authors: A M Malhas; J Granville-Chapman; P M Robinson; S Brookes-Fazakerley; M Walton; P Monga; S Bale; I Trail Journal: Bone Joint J Date: 2018-12 Impact factor: 5.082
Authors: Jason E Hsu; Surena Namdari; Matthew Baron; Andrew F Kuntz; Joseph A Abboud; G Russell Huffman; Gerald R Williams; David L Glaser Journal: Orthopedics Date: 2014-06 Impact factor: 1.390
Authors: Eric Wagner; Matthew T Houdek; Timothy Griffith; Bassem T Elhassan; Joaquin Sanchez-Sotelo; John W Sperling; Robert H Cofield Journal: J Bone Joint Surg Am Date: 2015-10-21 Impact factor: 5.284