Cemented versus uncemented fixation of second-generation Trabecular Metal glenoid components: minimum 5-year outcomes

Background Total shoulder arthroplasty with second generation porous tantalum glenoid implants (Trabecular Metal™) has shown good short-term outcomes, but mid-term outcomes are unknown. This study describes the clinical, radiographic, and patient-rated mid-term outcomes of total shoulder arthroplasty utilizing cemented Trabecular Metal™ glenoid components. Methods Patients who underwent anatomic total shoulder arthroplasty with cemented Trabecular Metal™ glenoid components for primary osteoarthritis were identified for minimum five-year follow-up. The primary outcome measure was implant survival; secondary outcome measures included patient-rated outcome scores, shoulder range of motion findings, and radiographic analysis. Results Twenty-seven patients were enrolled in the study. Twenty-one patients had full radiographic follow-up. Mean follow-up was 6.6 years. There was 100% implant survival. Shoulder range of motion significantly improved and the mean American Shoulder and Elbow Society score was 89.8. There was presence of metal debris radiographically in 24% of patients. Twenty-nine percent of patients had evidence of radiolucency. Fourteen percent of patients had moderate superior subluxation. Conclusion Total shoulder arthroplasty with second generation cemented Trabecular Metal™ glenoid components yielded good outcomes at mean 6.6-year follow-up. Metal debris incidence and clinical outcomes were similar to short-term findings. The presence of metal debris did not significantly affect clinical outcomes. Continued observation of these patients will elucidate longer-term implant survival.

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A Multi-Centre, Randomized Controlled Trial Comparing A Second-Generation Uncemented Trabecular Metal-Backed vs. Cemented Polyethylene Glenoid Component in Total Shoulder Arthroplasty: Two-Year Results

OrthoMedia ◽

10.1302/3114-220828 ◽

2022 ◽

Keyword(s):

Randomized Controlled Trial ◽

Shoulder Arthroplasty ◽

Second Generation ◽

Controlled Trial ◽

Total Shoulder Arthroplasty ◽

Glenoid Component ◽

Trabecular Metal ◽

Randomized Controlled

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Total shoulder arthroplasty with a second-generation tantalum trabecular metal-backed glenoid component

The Bone & Joint Journal ◽

10.1302/0301-620x.98b1.36620 ◽

2016 ◽

Vol 98-B (1) ◽

pp. 75-80 ◽

Cited By ~ 19

Author(s):

G. Merolla ◽

P. Chin ◽

T. M. Sasyniuk ◽

P. Paladini ◽

G. Porcellini

Keyword(s):

Shoulder Arthroplasty ◽

Second Generation ◽

Total Shoulder Arthroplasty ◽

Glenoid Component ◽

Trabecular Metal

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Two-year results of a multi-centre, randomized controlled trial comparing a second-generation uncemented trabecular metal-backed versus cemented polyethylene glenoid component in total shoulder arthroplasty

Bone & Joint Open ◽

10.1302/2633-1462.29.bjo-2021-0073.r1 ◽

2021 ◽

Vol 2 (9) ◽

pp. 728-736

Author(s):

Patrick Y. K. Chin ◽

William D. Regan ◽

Derek Plausinis ◽

Zane D. Zarzour ◽

Fay Leung ◽

...

Keyword(s):

Patient Reported Outcomes ◽

Second Generation ◽

Controlled Trial ◽

Total Shoulder Arthroplasty ◽

Glenoid Component ◽

Trabecular Metal ◽

Metal Debris ◽

Randomized Controlled ◽

Patient Reported

Aims To report early (two-year) postoperative findings from a randomized controlled trial (RCT) investigating disease-specific quality of life (QOL), clinical, patient-reported, and radiological outcomes in patients undergoing a total shoulder arthroplasty (TSA) with a second-generation uncemented trabecular metal (TM) glenoid versus a cemented polyethylene glenoid (POLY) component. Methods Five fellowship-trained surgeons from three centres participated. Patients aged between 18 and 79 years with a primary diagnosis of glenohumeral osteoarthritis were screened for eligibility. Patients were randomized intraoperatively to either a TM or POLY glenoid component. Study intervals were: baseline, six weeks, six-, 12-, and 24 months postoperatively. The primary outcome was the Western Ontario Osteoarthritis Shoulder QOL score. Radiological images were reviewed for metal debris. Mixed effects repeated measures analysis of variance for within and between group comparisons were performed. Results A total of 93 patients were randomized (46 TM; 47 POLY). No significant or clinically important differences were found with patient-reported outcomes at 24-month follow-up. Regarding the glenoid components, there were no complications or revision surgeries in either group. Grade 1 metal debris was observed in three (6.5%) patients with TM glenoids at 24 months but outcomes were not negatively impacted. Conclusion Early results from this RCT showed no differences in disease-specific QOL, radiographs, complication rates, or shoulder function between uncemented second-generation TM and cemented POLY glenoids at 24 months postoperatively. Revision surgeries and reoperations were reported in both groups, but none attributed to glenoid implant failure. At 24 months postoperatively, Grade 1 metal debris was found in 6.5% of patients with a TM glenoid but did not negatively influence patient-reported outcomes. Longer-term follow-up is needed and is underway. Cite this article: Bone Jt Open 2021;2(9):728–736.

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