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

2016 ◽  
Vol 98-B (1) ◽  
pp. 75-80 ◽  
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

Radiographic and clinical outcomes of second generation Trabecular Metal™ glenoid components in total shoulder arthroplasty

2020 ◽  
pp. 175857322090998
Author(s):  
Raymond E Chen ◽  
Alexander M Brown ◽  
Alexander S Greenstein ◽  
Sandeep Mannava ◽  
Ilya Voloshin
Keyword(s):  
Clinical Outcomes ◽  
Shoulder Arthroplasty ◽  
Second Generation ◽  
Total Shoulder Arthroplasty ◽  
Implant Survival ◽  
Trabecular Metal ◽  
Metal Debris ◽  
Shoulder Range Of Motion ◽  
Shoulder Range

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.

scholarly journals Short-Term Outcomes of the Grammont Reverse Shoulder Arthroplasty: Comparison between First and Second Generation Delta Prosthesis

Joints ◽  
2021 ◽  
Author(s):  
Riccardo Luigi Alberio ◽  
Marco Landrino ◽  
Paolo Fornara ◽  
Federico Alberto Grassi
Keyword(s):  
Shoulder Arthroplasty ◽  
Second Generation ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Radiographic Evaluation ◽  
Glenoid Component ◽  
Consecutive Series ◽  
Short Term ◽  
Component Loosening

Abstract Purpose This article compares short-term outcomes of two series of patients, who underwent reverse total shoulder arthroplasty (RTSA) with two different implants, both based on Grammont's principles: the Delta III (D-3) and the Delta Xtend (D-XT) prostheses. Methods The D-3 group included a consecutive series of 26 patients (mean age 75 years), that were treated between 2000 and 2006; the D-XT group included a consecutive series of 31 patients (mean age 72.5 years), for a total of 33 implants performed between 2011 and 2015. In both groups the most common diagnoses were cuff tear arthropathy (18 and 22 shoulders, respectively) and malunion of proximal humerus fractures (3 and 5). All procedures were performed by the same surgeon. Constant–Murley score (CMS) was used to assess clinical and functional outcomes. Radiographic evaluation included the true anteroposterior and axillary views. Results Twenty-three patients of the D-3 group and 22 patients (24 shoulders) of the D-XT group were evaluated at a mean follow-up of 42 months (range 26–84) and 44 months (range 26–66), respectively. Four complications occurred in the D-3 group (1 partial deltoid detachment, 1 dislocation, and 2 glenoid component loosening), while one early postoperative infection occurred in the D-XT group. Increases in elevation and CMS between preoperative and postoperative period were observed in both groups; only the D-XT group showed a slight improvement in rotations. The incidence of scapular notching was significantly different between the two groups: 100% for D-3 and 22.2% for D-XT in patients with a minimum follow-up of 5 years. Conclusion Prosthetic design evolution and greater acquaintance with this surgery have undoubtedly led to an improvement in short-term outcomes with second generation implants of RTSA. Future studies will have to ascertain whether newer implants, relying on biomechanical solutions alternative to Grammont's original concept, might provide additional advantages and minimize drawbacks.

scholarly journals 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

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.

scholarly journals Modern trabecular metal-backed glenoid components in total shoulder arthroplasty: What is the evidence? A systematic review

2020 ◽  
pp. 175857322091427
Author(s):  
Michael-Alexander Malahias ◽  
Dimitrios Chytas ◽  
Lazaros Kostretzis ◽  
Angelos Trellopoulos ◽  
Emmanouil Brilakis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Arthroplasty ◽  
Clinical Performance ◽  
Total Shoulder Arthroplasty ◽  
Glenoid Component ◽  
Trabecular Metal ◽  
Metal Debris ◽  
Cochrane Database

Background A number of papers have been published reporting on the clinical performance of modern trabecular metal-backed glenoid components in total shoulder arthroplasty. However, no systematic review of the literature has been published to date. Methods The US National Library of Medicine (PubMed/MEDLINE), and the Cochrane Database of Systematic Reviews and EMBASE were queried for publications from January 1980 to October 2019 utilizing keywords pertinent to total shoulder arthroplasty, trabecular metal, and clinical outcomes. Results Overall, seven articles were included for analysis (322 operated shoulders, mean follow-up range: 2–4 years). The survival rate of modern trabecular metal-backed glenoid components was 96% (309 out of 322 cases) at 43 months mean follow-up, while the rate of aseptic loosening was 0.3% (1 out of 322 cases). There were 35 cases (10.9%) with glenoid component radiolucency (one of them required revision), and 37 cases (11.5%) of metal debris formation, with four of them undergoing revision. Conclusions There was low quality evidence to show that the use of modern trabecular metal-backed glenoid components in total shoulder arthroplasty may be safe and effective at short-term follow-up. However, this analysis showed alarmingly high rates of both radiolucency of the glenoid component and metal debris formation which raise concern for potential failure of this glenoid component in the long term. Therefore, we feel that modern trabecular metal-backed glenoid components should be still used with caution as part of a structured surveillance or research program until we know if there is a detriment to the prosthesis in the medium to long term. Level: Systematic review, IV.

Failure of the Glenoid Component in Anatomic Total Shoulder Arthroplasty

2013 ◽  
Vol 95 (24) ◽  
pp. 2205-2212 ◽  
Author(s):  
Anastasios Papadonikolakis ◽  
Moni Blazej Neradilek ◽  
Frederick A Matsen
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Glenoid Component

scholarly journals Journey of the glenoid in anatomic total shoulder replacement

2018 ◽  
Vol 11 (2) ◽  
pp. 140-148 ◽  
Author(s):  
Alessandro Castagna ◽  
Raffaele Garofalo
Keyword(s):  
Shoulder Arthroplasty ◽  
Current Practice ◽  
Total Shoulder Arthroplasty ◽  
Shoulder Function ◽  
Patient Specific ◽  
Glenoid Component ◽  
Shoulder Replacement ◽  
Final Destination ◽  
Component Loosening

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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