Clinical and Radiographic Results of an All-Polyethylene Pegged Bone-Ingrowth Glenoid Component.

Loosening of the glenoid component continues to be the main cause of medium and long-term failure of shoulder replacements. The purpose of this study was to evaluate the early clinical and radiographic results following use of an all-polyethylene pegged glenoid component designed for hybrid (biological and cement) fixation. Eighty-three shoulders in 77 patients (mean age, 68.6 years) underwent total shoulder arthroplasty with a pegged hybrid-fixation component (bone-ingrowth glenoid and cemented peg). Outcomes were determined with the American Shoulder and Elbow Surgeons (ASES) score and the Oxford shoulder score. A detailed analysis of radiographs and fine-slice computed tomography (CT) images was performed to determine the extent of bone ingrowth between the flanges and the extent of radiolucent lines at the prosthesis-bone interface. The mean duration of follow-up was 46.7 months (range, 24 to 99 months). At the time of final follow-up, the median ASES score was 97 points (range, 43 to 100 points) and the median Oxford score was 48 points (range, 24 to 48 points). The median active forward elevation was 130° (range, 65° to 170°), median external rotation was 45° (range, 5° to 80°), and median internal rotation was to T11 (range, buttock to T4). Seventy-eight shoulders demonstrated a perfect Lazarus score for radiolucency (0, indicating no radiolucency). Sixty-eight shoulders demonstrated complete osseointegration, with bone ingrowth between all of the flanges seen on coronal CT; 5 demonstrated partial osseointegration; and 10 demonstrated osteolysis around the central peg. Most radiolucent lines were in the inferior Yian zones. There were no correlations between the Yian CT scores and either the ASES or Oxford score (rho = 0.13 and 0.07, respectively). Total shoulder arthroplasty with an all-polyethylene pegged glenoid component, utilizing hybrid fixation, demonstrated excellent clinical and radiographic results at the time of early follow-up. Radiolucent lines were seen most commonly around the inferior pegs of the prosthesis, and this may represent an incipient mode of failure. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Wijeratna M ，Taylor DM ，Lee S ，Hoy G ，Evans MC ... -  《-》

Total shoulder arthroplasty with an all-polyethylene pegged bone-ingrowth glenoid component: a clinical and radiographic outcome study.

Wirth MA ，Loredo R ，Garcia G ，Rockwood CA Jr ，Southworth C ，Iannotti JP ... -  《-》

Total shoulder replacement using a bone ingrowth central peg polyethylene glenoid component: a prospective clinical and computed tomography study with short- to mid-term follow-up.

Merolla G ，Ciaramella G ，Fabbri E ，Walch G ，Paladini P ，Porcellini G ... -  《-》

Medium-Term Clinical and Radiographic Results of an All-Polyethylene, Pegged, Bone-Ingrowth Glenoid Component: A Concise Follow-up of a Previous Report.

We previously reported the mean 4-year outcomes of anatomic total shoulder replacement using an all-polyethylene, pegged, hybrid-fixation (bone ingrowth and cement) glenoid component. In the present study, we report on that patient cohort after another 4 years of follow-up (mean, 101 months; range, 77 to 146 months). At that time, the median American Shoulder and Elbow Surgeons (ASES) score was 92 points (interquartile range [IQR], 81.7 to 98.3) and the median Oxford Shoulder Score was 47 points (IQR, 41 to 48). Osseointegration, demonstrated by bone ingrowth between the flanges on the central peg as seen on coronal computed tomography (CT), was complete in 75% of the shoulders, partial in 21%, and absent in 4%. There were radiolucent lines at the bone-prosthesis interface on CT, with a median Yian score of 1 (IQR, 0 to 2; range, 0 to 18). The conclusion in the present study was that shoulder arthroplasty with an all-polyethylene, hybrid-fixation (bone ingrowth and cement) pegged glenoid component has durable clinical and radiographic outcomes at medium-term follow-up. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Borbas P ，Taylor DM ，Lee S ，Wijeratna M ，Hoy G ，Evans MC ... -  《-》

Radiographic and clinical outcomes of total shoulder arthroplasty with an all-polyethylene pegged bone ingrowth glenoid component: prospective short- to medium-term follow-up.

Glenoid components often cause total shoulder arthroplasty failure. This study examines short-term to midterm radiographic and clinical results of a hybrid glenoid component with 3 cemented peripheral pegs and a central peg, which allows biologic fixation with use of native humeral head autograft. In 4 years, 80 glenoid components were implanted during primary total shoulder arthroplasty with at least 2-year follow-up data. Within 12 months, 4 shoulders were revised and excluded from final analyses. Seven patients did not complete their questionnaires. Outcomes data included the American Shoulder and Elbow Surgeons (ASES) questionnaire, Constant score, and satisfaction score. A shoulder and elbow fellowship-trained surgeon, not involved in the care of these patients, analyzed radiographs for radiolucent lines, glenoid seating, and radiodensity in between the flanges of the central peg. Only 1 of 80 shoulders was revised for aseptic glenoid loosening. At final follow-up, 81.6% had a radiolucency grade of 0 or 1. Nearly 90% had a glenoid seating grade of A or B. Grade 2 or 3 bone around the central peg was seen in 88.2%. No statistical association existed between Walch glenoid types and radiolucency grades, bone grades around the central peg, perfect radiolucency grade, seating grade, and grade 3 bone around the central peg. There was significant improvement in mean ASES score, adjusted ASES pain score, Constant score, and satisfaction score as well as in forward flexion, abduction, and external rotation. The hybrid glenoid can produce stable radiographic and clinical outcomes at short- to medium-term follow-up.

Parks DL ，Casagrande DJ ，Schrumpf MA ，Harmsen SM ，Norris TR ，Kelly JD 2nd ... -  《-》