Radiographic comparison of pegged and keeled glenoid components using modern cementing techniques: a prospective randomized study.

Modern cementing techniques have improved glenoid fixation, reduced glenoid lucency seen with keeled components, and may eliminate differences attributable to glenoid design. The purpose of this study was to determine the effect of glenoid design on immediate and follow-up radiographic lucency of pegged and keeled glenoid components, using modern cementing techniques. Fifty-three total shoulder arthroplasties were performed in patients with primary glenohumeral osteoarthritis. Patients were randomized prospectively to receive either a pegged or keeled glenoid component. Three raters graded radiographic glenoid lucencies. On immediate radiographs, there was no significant difference in the rate of glenoid lucency between pegged (0%) and keeled (15%) glenoid components (P = .128). However, after an average of 26 months, the rate of glenoid lucency was significantly higher in patients with keeled components (46%) compared to patients with pegged components (15%) (P = .003). Even with modern cementing techniques, pegged glenoid components remain radiographically superior to keeled glenoid components.

Edwards TB ，Labriola JE ，Stanley RJ ，O'Connor DP ，Elkousy HA ，Gartsman GM ... -  《-》

Radiographic and clinical comparison of pegged and keeled glenoid components using modern cementing techniques: midterm results of a prospective randomized study.

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. 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. 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). 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.

Kilian CM ，Press CM ，Smith KM ，O'Connor DP ，Morris BJ ，Elkousy HA ，Gartsman GM ，Edwards TB ... -  《-》

Radiographic comparison of pegged and keeled glenoid components.

Gartsman GM ，Elkousy HA ，Warnock KM ，Edwards TB ，O'Connor DP ... -  《JOURNAL OF SHOULDER AND ELBOW SURGERY》

Stability of cemented in-line pegged glenoid compared with keeled glenoid components in total shoulder arthroplasty.

Rahme H ，Mattsson P ，Wikblad L ，Nowak J ，Larsson S ... -  《-》

Pegged versus keeled glenoid components in total shoulder arthroplasty.

Loosening of the glenoid component is a common complication in shoulder arthroplasty. We proposed to radiographically and clinically investigate the outcomes of keeled and pegged glenoid components to test the hypothesis that these implants would have equivalent performance. One hundred patients undergoing primary shoulder arthroplasty for osteoarthritis were reviewed. Fifty patients had pegged glenoid components, and fifty had keeled components. Standardized radiographs were taken. Preoperative films classified the severity of degenerative change. The postoperative films were analyzed for radiolucent lines and shift in component position-at-risk signs for loosening. Mean radiographic follow-up was 51.3 months (range, 24-90 months) for the keeled group and 45.7 months (range, 27-98 months) for the pegged group. There were no differences in the degree of preoperative arthritic change between groups. Both groups had significant improvement in motion and pain (P < .001) postoperatively, with no differences in clinical outcome between cohorts (P > or = .20). Initial radiographs showed no radiolucencies around the pegs in 46 implants or around the keel in 49 components. At final follow-up, 10 glenoid implants were found to be at risk for loosening, 6 (12%) in the pegged group and 4 (8%) in the keeled group (P = .74). Initial postoperative radiographs with pegged and keeled components show a low rate of radiolucent lines. These radiolucencies develop over time. However, there is no difference in clinical or radiographic outcomes between pegged and keeled components at intermediate-term follow-up.

Throckmorton TW ，Zarkadas PC ，Sperling JW ，Cofield RH ... -  《-》