A comparison of onlay versus inlay glenoid component loosening in total shoulder arthroplasty

Gagliano, Jeffrey R.; Helms, Sarah M.; Colbath, Gregory; Przestrzelski, Breanne; Hawkins, Richard J.; DesJardins, John D.

doi:10.1016/j.jse.2017.01.018

Cited by 42 publications

(24 citation statements)

References 27 publications

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“…Inset or inlay glenoids are more recent designs and therefore lack long-term assessment to date. Our results showed that 80.6% of all glenoids had lucent lines less than 1 mm and none had greater than 2 mm, though longer term follow-up is needed to conclude implant stability for inlay or inset glenoid components as in other reports 12, 14, 15…”

Section: Discussionsupporting

confidence: 56%

“…Both inset 15 and inlay 12 glenoids follow a similar placement concept that lies within the original glenoid joint line that provides protection from the rocking-horse phenomenon and shear forces during GH translation and results in a significantly lower risk of loosening in basic science studies 12, 15. In 2017, Gagliano et al 12 compared the loading characteristics of onlay and inlay glenoid components after TSA in 8 matched cadaveric shoulder pairs. The study showed that the combination of a nonspherical HH and inlay glenoid component achieved similar contact forces as seen in the native glenoid periphery, whereas onlay specimens were exposed to increased edge loading leading to loosening.…”

Section: Discussionmentioning

confidence: 99%

“…This is contrasted with improved glenoid access in stemmed and stemless procedures when using conventional onlay preparation techniques. The distinction between onlay and inlay or inset techniques is newer concepts in glenoid replacement 12, 14, 15. The inlay goal is to improve component stability, avoid joint line lateralization, and intra-articular volume changes.…”

mentioning

confidence: 99%

“…The inlay goal is to improve component stability, avoid joint line lateralization, and intra-articular volume changes. On the humeral side, stemmed, stemless, and onlay resurfacing arthroplasty predominantly use spherical components despite a growing body of evidence that supports the use of nonspherical implants12, 15, 21, 25 that reflect the anatomic differences in the larger superior-inferior (SI) and smaller anterior-posterior (AP) dimensions 18, 20, 24, 44…”

mentioning

confidence: 99%

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Total shoulder arthroplasty with nonspherical humeral head and inlay glenoid replacement: clinical results comparing concentric and nonconcentric glenoid stages in primary shoulder arthritis

et al. 2019

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BackgroundGlenoid morphology can influence the outcomes of total shoulder arthroplasty. This study examines the results of a new technique according to preoperative glenoid staging. We hypothesized that there would be no statistically significant difference in outcomes between Levine concentric (Walch A) and Levine nonconcentric (Walch B) glenoids treated for primary glenohumeral arthritis using nonspherical humeral head and inlay glenoid replacement.MethodsThis retrospective case series included 31 shoulders in 29 patients (25 male, 4 female), with an average age of 58.5 years. Outcomes included the Penn Shoulder Score (PSS), visual analog scale for pain (VAS-Pain), range of motion, radiographic analysis, and complications. Inclusion criteria were primary glenohumeral arthritis, intact rotator cuff, and no prior open shoulder surgeries.ResultsMean follow-up was 42.6 months (range, 24-74 months). The study included 7 concentric and 24 nonconcentric glenoids. Outcomes comparison showed no statistically significant differences in PSS domains including Pain (P = .92), Function (P = .98), Satisfaction (P = .89), and Total (P = .98); forward flexion (P = .78); external rotation (P = .64); and VAS-Pain (P = 0.12). At the last follow-up, the mean PSS Pain was 25.3/30, Function 52.7/60, Satisfaction 8.4/10, and Total 87.0/100. The mean forward flexion was 167.3°, external rotation 56.6°, and VAS-Pain 0.9. There were no signs of periprosthetic fracture, component loosening, osteolysis, and hardware failure, and no revisions or 90-day rehospitalizations were required. One patient was prophylactically treated with oral antibiotics for a history of prior infection and 1 patient required a later open biceps tenodesis after a traumatic proximal biceps rupture postoperatively.ConclusionNonspherical shoulder arthroplasty with inlay glenoid replacement demonstrated excellent clinical benefits for both concentric and nonconcentric glenoids. The technique appears to be a promising option for glenohumeral arthritis even in the presence of posterior glenoid erosion.

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Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Total shoulder arthroplasty with nonspherical humeral head and inlay glenoid replacement: clinical results comparing concentric and nonconcentric glenoid stages in primary shoulder arthritis

et al. 2019

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“…Biomechanical research supports the idea that inlay components resist loosening better than onlay designs because there is a better resistance to the rocking horse phenomenon. 34,35 However, there is a concern that contact of the humeral head with native tissue may cause pain, as in hemiarthroplasty. 34 Although some studies showed good clinical outcome using this implant, 36 longer follow-up studies are awaited to better evaluate this design.…”

Section: All-pe Glenoidmentioning

confidence: 99%

Journey of the glenoid in anatomic total shoulder replacement

Castagna

Garofalo

2018

Shoulder & Elbow

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Anatomic total shoulder arthroplasty (TSR) has been shown to generate good to excellent results for patients with osteoarthritis and a functioning rotator cuff. Many studies have reported that the glenoid component loosening and failure remain the most common long-term complication of total shoulder arthroplasty. The approach to glenoid component is critical because a surgeon should consider patient-specific anatomy, preserving bone stock and joint line restoration, for a good and durable shoulder function. Over the years, different glenoid design and materials have been tried in various configurations. These include cemented polyethylene, uncemented metal-backed and hybrid implants. Although advances in biomechanics, design and tribology have improved our understanding of the glenoid, the journey of the glenoid component in anatomic total shoulder arthroplasty has not yet reached its final destination. This article attempts to describe the evolution of the glenoid component in anatomic TSR and current practice.

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Total Shoulder Arthroplasty for Glenohumeral Arthritis in a Young Patient

Mahoney¹,

Hasan

2022

Glenohumeral Osteoarthritis in the Young Patient

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A comparison of onlay versus inlay glenoid component loosening in total shoulder arthroplasty

Cited by 42 publications

References 27 publications

Total shoulder arthroplasty with nonspherical humeral head and inlay glenoid replacement: clinical results comparing concentric and nonconcentric glenoid stages in primary shoulder arthritis

Total shoulder arthroplasty with nonspherical humeral head and inlay glenoid replacement: clinical results comparing concentric and nonconcentric glenoid stages in primary shoulder arthritis

Journey of the glenoid in anatomic total shoulder replacement

Total Shoulder Arthroplasty for Glenohumeral Arthritis in a Young Patient

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