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

Background Recessed mini-glenoid components provide an alternative to total shoulder replacement that may avoid some of the known shortcomings and complications associated with shoulder hemiarthroplasty or standard glenoid components in difficult cases. This study reports survivorship, radiological and clinical outcomes of a recessed mini-glenoid implant in a consecutive cohort. Methods Retrospective cohort study reporting outcomes of 28 consecutive shoulders (27 patients) following total shoulder replacement using a recessed, cemented mini-glenoid implant at two sites. Results The most frequent diagnosis was primary osteoarthritis (79%); glenoid morphology was Walch Type A (67%), B1 15%, B2 10% and C 10%. At final follow-up, pain was 16.3 (SD = 23.1), American Shoulder and Elbow Score was 64.5 (SD = 31.9) and (normalized) Constant score was 83.0 (SD = 20.7). Implant survivorship at average final follow-up of seven years (3–13) was 96.4%. Seven mini-glenoids showed small peripheral radiolucent lines at one-year X-ray follow-up but were non-progressive on subsequent imaging. Discussion Recessed polyethylene mini-glenoid is an attractive alternative for shoulder arthroplasty and provides an intermediate solution between standard glenoid components and hemiarthroplasty. Our medium to long-term results demonstrate reliable clinical outcomes, absence of glenoid erosion, low complication rate and satisfactory implant survivorship.

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The influence of fatty infiltration and muscle atrophy of the rotator cuff muscles on midterm functional outcomes in total shoulder resurfacing at six years’ follow-up

Shoulder & Elbow ◽

10.1177/1758573218811655 ◽

2018 ◽

Vol 12 (2) ◽

pp. 91-98

Author(s):

Gray AD Edwards ◽

Philip A McCann ◽

Michael R Whitehouse ◽

Charles J Wakeley ◽

Partha P Sarangi

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Rotator Cuff ◽

Muscle Atrophy ◽

Functional Outcomes ◽

Fatty Infiltration ◽

Resonance Imaging ◽

Shoulder Replacement ◽

Total Shoulder Replacement

Background We report functional outcomes at six years in patients with varying degrees of fatty infiltration and atrophy of the rotator cuff muscles who have undergone anatomic total shoulder replacement. Methods A retrospective analysis of case notes and magnetic resonance imaging scans of patients undergoing total shoulder replacement for primary glenohumeral arthritis was performed. Patients were grouped based upon their pre-operative magnetic resonance imaging findings for fatty infiltration, muscle area and tendinopathy. Post-operative functional outcomes were assessed using the Oxford Shoulder Score and Quick Disabilities of the Arm, Shoulder and Hand score. Post-operative measurements were made for active shoulder movements. Results Thirty-two patients were reviewed at a mean of 67 months following surgery. All patients demonstrated fatty infiltration on their pre-operative magnetic resonance imaging scan. Muscle atrophy was shown in 22 patients and 12 had tendinopathy. Multiple regression analysis showed no correlation between the Oxford Shoulder Score (p = 0.443), the Quick Disabilities of the Arm, Shoulder and Hand score (p = 0.419), forward flexion (p = 0.170), external rotation (p = 0.755) and any of the pre-operative independent variables. Discussion The degree of fatty infiltration, muscle atrophy and tendinopathy of the rotator cuff muscle on pre-operative magnetic resonance imaging scanning is not associated with functional outcome score or functional movement at medium-term follow-up following total shoulder replacement. Level of evidence IV

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Hybrid Glenoid Designs in Anatomic Total Shoulder Arthroplasty: A Systematic Review

HSS Journal ® ◽

10.1177/15563316211040829 ◽

2021 ◽

pp. 155633162110408

Author(s):

Ahmed Haleem ◽

Phelopater Sedrak ◽

Chetan Gohal ◽

George S. Athwal ◽

Moin Khan ◽

...

Keyword(s):

Los Angeles ◽

Shoulder Arthroplasty ◽

Bone Ingrowth ◽

External Rotation ◽

Total Shoulder Arthroplasty ◽

Glenoid Component ◽

Patient Reported

Background: Hybrid glenoid components in total shoulder arthroplasty (TSA) utilize both polyethylene and metal components to provide short-term stability and long-term biologic fixation through bone ingrowth. Questions/Purpose: We sought to systematically review the literature for studies that assessed outcomes of TSA performed using hybrid glenoid components. Methods: PubMed, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Embase were searched systematically for articles measuring clinical and patient-reported outcomes and rates of complication and revision following TSA using a hybrid glenoid component. Results: Seven studies with 593 shoulders were included in this review. The mean age of patients was 65 ± 1 years, and 46% of the population was male. Mean follow-up was 50 months (4.2 years). The overall complication rate was 7% and rate of revision was 2.5%; glenoid radiolucency was present in 33% of shoulders at mean follow-up of 50 months. Mean improvements in forward elevation, external rotation, internal rotation score, and abduction were 49°, 28°, 2 points, and 42°, respectively. Mean improvements in Constant, American Shoulder and Elbow Surgeons (ASES), and University of California, Los Angeles (UCLA) scores were 36 points, 52 points, and 17 points, respectively. Conclusion: Our review found that TSA using hybrid glenoid components results in low rates of complication and revision at early follow-up. Long-term studies are warranted to understand more fully the role of hybrid glenoid components in TSA.

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Failed shoulder stabilization procedure in the elderly: reverse shoulder replacement is the treatment ultimum

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20193848 ◽

2019 ◽

Vol 5 (5) ◽

pp. 982

Author(s):

Subramanian Kanthalu Narayanan ◽

Navaladi Muthusamy ◽

Vanaj Kumar Pauldhurai

Keyword(s):

Rotator Cuff ◽

Shoulder Instability ◽

The Elderly ◽

Bone Defects ◽

Anterior Dislocation ◽

Glenoid Component ◽

Shoulder Replacement ◽

Active Flexion ◽

Reverse Shoulder Replacement

<p class="abstract">Shoulder instability, though often seen in younger individuals it can also occur in the elderly. Shoulder instability in the elderly is often missed and definitive management gets delayed. Treatment delay has a significant influence on the choice of surgical procedure and its functional outcome. We report a 77 year old female who presented with a missed anterior dislocation of the glenohumeral joint. She had undergone an open Latarjet procedure for shoulder instability eight months before her presentation. Considering her age, humeral head bone defects, rotator cuff tear and degenerative changes in the joint we opted for a Reverse Shoulder Replacement in her. The patient now has a pain free, stable and mobile shoulder joint. Her pre-operative Constant score was 11 which improved to 67 at 6 months follow up. Now after 12 months follow up, she has active flexion up to 150°, abduction- 90°, external rotation- 10°, internal rotation- 30<sup>0</sup> and extension- 50°. Reverse shoulder replacement is a viable treatment option for chronic locked shoulder dislocations with concomitant rotator cuff lesions. Though there is a concern about failure of the glenoid component due to bone defects, RSA is still preferable in elderly patients with low functional demand.</p>

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Results of Cemented Total Shoulder Replacement with a Minimum Follow-up of Ten Years

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.k.00580 ◽

2012 ◽

Vol 94 (23) ◽

pp. e171 ◽

Cited By ~ 89

Author(s):

Patric Raiss ◽

Markus Schmitt ◽

Thomas Bruckner ◽

Philip Kasten ◽

Guido Pape ◽

...

Keyword(s):

Shoulder Replacement ◽

Total Shoulder Replacement

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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

Shoulder & Elbow ◽

10.1177/1758573220944168 ◽

2020 ◽

pp. 175857322094416

Author(s):

Michael-Alexander Malahias ◽

Lazaros Kostretzis ◽

Ioannis Gkiatas ◽

Efstathios Chronopoulos ◽

Emmanouil Brilakis ◽

...

Keyword(s):

Systematic Review ◽

Clinical Performance ◽

Bone Ingrowth ◽

Total Shoulder Arthroplasty ◽

Glenoid Component ◽

Level Of Evidence ◽

Tissue Integration ◽

Radiographic Outcomes ◽

Component Design

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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