Early migration of a partially cemented fluted glenoid component inserted using a cannulated preparation system

Nuttall, D.; Birch, A.; Haines, Janet; Watts, AC; Trail, I. A.

doi:10.1302/0301-620x.99b5.bjj-2016-0745.r1

Cited by 11 publications

(19 citation statements)

References 27 publications

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“…A total of 25 studies were noncomparative. Of these studies, 9 examined keeled glenoid fixations9, 12, 15, 19, 23, 31, 50, 51, 54 and 16 examined pegged glenoid fixations5, 7, 14, 25, 26, 27, 28, 29, 35, 36, 38, 39, 42, 45, 49, 53 (Table I). Among these studies, 10 reported ASES scores, 16 reported Constant scores, 19 reported radiolucency rates, and 19 reported revision rates.…”

Section: Resultsmentioning

confidence: 99%

A comparison of pegged vs. keeled glenoid components regarding functional and radiographic outcomes in anatomic total shoulder arthroplasty: a systematic review and meta-analysis

et al. 2019

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BackgroundThe number of total shoulder arthroplasties (TSAs) performed is increasing annually, with a continued effort to improve outcomes using new techniques and materials. In anatomic TSAs, the main options for glenoid fixation currently involve keeled or pegged components. The aim of this review was to determine which fixation option provides optimal long-term functional outcomes with decreased rates of revision surgery and radiolucency.MethodsThe MEDLINE, Embase, PubMed, and Cochrane databases were searched from 2007 to July 10, 2017, for all articles that examined TSAs using either pegged or keeled glenoid fixations. All studies were screened in duplicate for eligibility. Two separate analyses were completed examining noncomparative and comparative studies independently.ResultsA total of 7 comparative studies and 25 noncomparative studies were included in the final analysis. Included in the analysis were 4 randomized (level I) studies, 1 level II study, 8 level III studies, and 19 level IV studies. Meta-analysis of the comparative studies demonstrated a higher rate of revision surgery with keeled fixations compared with pegged fixations (odds ratio, 6.22; 95% confidence interval [CI], 1.38-28.1; P = .02). No significant difference was found with respect to functional outcomes, such as the American Shoulder and Elbow Surgeons score (mean difference, 9.54; 95% CI, –8.25 to 27.34; P = .29) and Constant score (mean difference, 5.31; 95% CI, –12.28 to 22.89; P = .55), as well as radiolucency rates (odds ratio, 1.89; 95% CI, 0.56−6.39; P = .30).ConclusionPegged glenoid fixation may result in a decreased risk of revision TSAs, but no significant differences in patient-reported outcomes have been identified to date.

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Section: Resultsmentioning

confidence: 99%

A comparison of pegged vs. keeled glenoid components regarding functional and radiographic outcomes in anatomic total shoulder arthroplasty: a systematic review and meta-analysis

et al. 2019

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“…Finally, 13 articles were eligible for inclusion in the qualitative analysis. [18][19][20][21][22][23][24][25][26][27][28][29][30] The corresponding PRISMA chart of the literature search results is shown in Figure 1.…”

Section: Study Selectionmentioning

confidence: 99%

“…One study 25 was Level II, while 12 studies [18][19][20][21][22][23][24][26][27][28][29][30] were Level IV.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Five studies 20,25,26,28,29 were prospective, while eight studies were retrospective. 18,19,[21][22][23][24]27,30 The mean modified Coleman methodology score of the review was 60.9/100 (range 38.2 3 to 66 24 ) indicating a fair level for overall methodological quality.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In total, 560 cases treated with partially cemented allpolyethylene pegged bone-ingrowth glenoid components were included in this review. Twelve studies [19][20][21][22][23][24][25][26][27][28][29][30] reported gender distribution in the patient cohort (overall 52.9% males; 275 out of 520). The mean age per study ranged from 62.3 26 years to 74.6 19 years.…”

Section: Demographicsmentioning

confidence: 99%

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Clinical and radiographic outcomes of total shoulder arthroplasty with a partially cemented all-polyethylene pegged bone-ingrowth glenoid component: a systematic review

et al. 2020

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Background Several articles have been published reporting on the clinical performance of a novel pegged, all-polyethylene glenoid component design which features a central peg, circumferentially fluted, interference-fit peg for tissue integration and three small peripheral pegs for cementing. However, no systematic review exists to this date. Methods The US National Library of Medicine (PubMed/MEDLINE), EMBASE, and the Cochrane Database of Systematic Reviews were queried for publications up to May 2020. Results Overall, 13 articles were included for analysis (560 operated shoulders, range of mean follow-up: 2–6 years). The survival rate was 98.2% (550 out of 560 cases), while the rate of aseptic loosening was 0.2% (1 out of 560 cases). There were 139 cases (out of 399 reported; 34.1%) with peri-glenoid radiolucency, and 35 cases (out of 223 reported; 15.7%) of asymptomatic central peg osteolysis, with 1 of them undergoing revision. Conclusions There was fair quality of evidence to show that partially cemented all-polyethylene pegged bone-ingrowth glenoid components produce promising results, with a low revision rate in the short- to medium-term follow-up. Nevertheless, this analysis showed high rates of both radiolucency of the glenoid component and osteolysis around the central peg which raise concern for potential failure of this glenoid component in the long-term follow-up. Level of evidence Systematic review, IV.

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Validation of a 3D CT imaging method for quantifying implant migration following anatomic total shoulder arthroplasty

Jun

Ricchetti

Haladik

et al. 2021

Journal Orthopaedic Research

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Glenoid component loosening remains a common complication following anatomic total shoulder arthroplasty (TSA); however, plain radiographs are unable to accurately detect early implant migration. The purpose of this study was to validate the accuracy of a method of postoperative, three-dimensional (3D) computed tomography (CT) imaging with metal artifact reduction (MAR) to detect glenoid component migration following anatomic TSA. Tantalum bead markers were inserted into polyethylene glenoid components for implant detection on 3D CT. In-vitro validation was performed using a glenoid component placed into a scapula sawbone and incrementally translated and rotated, with MAR 3D CT acquired at each test position. Accuracy was evaluated by root mean square error (RMSE). In-vivo validation was performed on six patients who underwent anatomic TSA, with two postoperative CT scans acquired in each patient and marker-based radiostereometric analysis (RSA) performed on the same days. Glenoid component migration was calculated relative to a scapular coordinate system for both MAR 3D CT and RSA. Accuracy was evaluated by RMSE and paired Student's t-tests.The largest RMSE on in-vitro testing was 0.24 mm in translation and 0.11°in rotation, and on in-vivo testing was 0.47 mm in translation and 1.04°in rotation. There were no significant differences between MAR 3D CT and RSA measurement methods. MAR 3D CT imaging is capable of quantifying glenoid component migration with a high level of accuracy. MAR 3D CT imaging is advantageous over RSA because it is readily available clinically and can also be used to evaluate the implant-bone interface.

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Early migration of a partially cemented fluted glenoid component inserted using a cannulated preparation system

Abstract: Rapid early migration associated with focal lucency and absence of osseointegration was observed in three of 11 glenoid components, suggesting that lack of initial stability leads to early movement and failure of osseointegration. Cite this article: 2017;99-B:674-9.

Cited by 11 publications

References 27 publications

A comparison of pegged vs. keeled glenoid components regarding functional and radiographic outcomes in anatomic total shoulder arthroplasty: a systematic review and meta-analysis

A comparison of pegged vs. keeled glenoid components regarding functional and radiographic outcomes in anatomic total shoulder arthroplasty: a systematic review and meta-analysis

Clinical and radiographic outcomes of total shoulder arthroplasty with a partially cemented all-polyethylene pegged bone-ingrowth glenoid component: a systematic review

Validation of a 3D CT imaging method for quantifying implant migration following anatomic total shoulder arthroplasty

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