Midterm results of a total shoulder prosthesis fixed with a cementless glenoid component

• Published in: Journal of shoulder and elbow surgery 2013-05, Vol.22 (5), p.628-635
• Main Authors: Montoya, Fredy, MD, Magosch, Petra, MD, Scheiderer, Bastian, MD, Lichtenberg, Sven, MD, Melean, Patricio, MD, Habermeyer, Peter, MD, PhD
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Arthroplasty, Replacement - adverse effects; Bone Cements; bone ingrowth; cementless glenoid component; Female; Humans; Joint Prosthesis; loosening; Male; Middle Aged; Orthopedics; Osteoarthritis - surgery; Prosthesis Failure; radiolucent lines; Recovery of Function; Reoperation; Scapula - surgery; Shoulder Joint - surgery; shoulder osteoarthritis; Total shoulder arthroplasty; Treatment Outcome
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2012.07.005

Background The aim of this study was to evaluate the midterm results and complications of a total shoulder arthroplasty implanted with a metal-backed, bone-ingrowth glenoid component. Materials and methods In total, 62 patients (65 shoulders) diagnosed with primary osteoarthritis were treated with total shoulder arthroplasty with a cementless glenoid component. The mean age was 66 years (range, 54-85 years). Fifty-three patients were evaluated after a mean of 64 months (range, 26-85 months). Functional results were documented by use of the age- and sex-adjusted Constant score. Radiolucent line (RLL) assessment of the glenoid component was performed by use of true anteroposterior and axillary views. Results The Constant score improved significantly from 49% preoperatively to 89.8% postoperatively ( P  < .0001). Active range of motion improved significantly for flexion (from 118° to 146°), abduction (from 87° to 133°), and external rotation (from 21° to 44°) ( P < .0001). In 3 cases (5.7%), RLLs of 1 mm or less were present, and 1 case (1.8%) had an RLL of 2 mm or less in 1 zone. Glenoid component loosening occurred in 5 cases (9.4%) because of breakage of the cage screw. Four of these patients presented preoperatively with a type B1 glenoid and one patient with type A2. Two of the patients who underwent revision also had a complete tear of the rotator cuff. The revision rate was 11.3% (6 patients) after a mean of 68 months. Conclusion After midterm follow-up, clinical outcomes of patients operated on with a cementless, metal-backed glenoid implant improved significantly. However, an unacceptable rate of complications and revisions was found. Glenoid loosening predominantly occurred in patients with preoperative eccentric glenoid morphology and was also related to cranial migration of the proximal humerus during the follow-up period.