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Survival of the pegged glenoid component in shoulder arthroplasty: part II.

Abstract：

BACKGROUND:Loosening of the glenoid component is a primary reason for failure of an anatomic shoulder arthroplasty. Pegged glenoids were designed in an effort to outperform keeled components. This study evaluated the midterm clinical and radiographic survival of a single implant design with implantation of an in-line pegged glenoid component and identified risk factors for radiographic loosening and clinical failure. MATERIALS AND METHODS:There were 330 total shoulder arthroplasties that had been implanted with a cemented, all-polyethylene, in-line pegged glenoid component evaluated with an average clinical follow-up of 7.2 years. Of these shoulders, 287 had presurgical, initial postsurgical, and late postsurgical radiographs (mean radiographic follow-up, 7.0 years). RESULTS:At most recent follow-up, 30 glenoid components had been revised for aseptic loosening. This translated to a rate of glenoid component survival free from revision for all 330 shoulders of 99% at 5 years and 83% at 10 years. Of 287 glenoid components, 120 were considered loose on the basis of radiographic evaluation. Four humeral components were considered loose. Component survival (Kaplan-Meier) free from radiographic failure at 5 and 10 years was 92% and 43%. Severe presurgical glenoid erosion (Walch A2, B2, C) and patient age <65 years were risk factors for radiographic failure. Late humeral head subluxation was associated with radiographic failure. CONCLUSION:Despite the predominant thinking that pegged glenoid components may be superior to keeled designs, midterm radiographic and clinical failure rates were high with this pegged component design, particularly after 5 years. Advanced presurgical glenoid erosion and younger patient age are risk factors for radiographic loosening. Revision rates underestimate radiographic glenoid loosening.

journal_name

J Shoulder Elbow Surg

journal_title

Journal of shoulder and elbow surgery

authors

McLendon PB,Schoch BS,Sperling JW,Sánchez-Sotelo J,Schleck CD,Cofield RH

doi

10.1016/j.jse.2016.12.068

subject

Has Abstract

pub_date

2017-08-01 00:00:00

pages

1469-1476

issue

8

eissn

1058-2746

issn

1532-6500

pii

S1058-2746(17)30010-1

journal_volume

26

pub_type

杂志文章

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