CT scan evaluation of glenoid component fixation: a prospective study of 27 minimally cemented shoulder arthroplasties
Glenoid component failure is the most common complication of total shoulder arthroplasty. It can be correlated with failure of the component itself to resist wear and deformation, failure of fixation or failure of the glenoid bone. Anchor Peg Glenoid component (Depuy®) seems to have a higher bone fixation in biomechanical canine model: it is a all-polyethylene, concave component with one circumferentially fluted, central, interference-fit peg and three small cemented peripheral pegs.
Materials and methods
We realized a prospective study of Anchor Peg total shoulder arthroplasty, included 27 patients suffering from primary arthrosis or arthritis, without rotator cuff tear. A clinical and radiographic evaluation was performed at 3 months, 1 and 2 years; a CT scan was made in postoperative and analyzed central peg’s bone integration 1 year later.
Improvement of postoperative Constant score and radiographic good results were correlated with satisfactory subjective results reported by patients. We observed radiolucent lines under glenoid component in 3 cases. Twenty-six CT scans were available at 1 year: it showed complete bone integration around the central peg in 21 cases and partial peripheral bone integration in four cases. Only one patient had any tissue integration around the peg, probably because of his implantation near cortical bone of scapular spine.
Long-term result of arthroplasty is correlated with glenoid durable fixation to underlying bone: this study shows higher fixation of glenoid component with bone integration of central peg. However, these results will have to be confirmed in a later revision.
- Martin SD, Zurakowski D, Thornhill TS (2005) Uncemented glenoid component in total shoulder arthroplasty. Survivorship and outcomes. J Bone Joint Surg Am 87:1284–1292 CrossRef
- Tammachote N, Sperling JW, Vathana T, Cofield RH, Harmsen WS, Schleck CD (2009) Long-term results of cemented metal-backed glenoid components for osteoarthritis of the shoulder. J Bone Joint Surg Am 91:1965–1972 CrossRef
- Nuttall D, Haines JF, Trail II (2007) A study of the micromovement of pegged and keeled glenoid components compared using radiostereometric analysis. J Should Elb Surg 16(3 Suppl):S65–S70 CrossRef
- Giori NJ, Beaupré GS, Carter DR (1990) The influence of fixation peg design on the shear stability of prosthetic implants. J Orthop Res 8:892–898 CrossRef
- Edwards TB, Labriola JE, Stanley RJ, O’Connor DP, Elkousy HA, Gartsman GM (2010) Radiographic comparison of pegged and keeled glenoid components using modern cementing techniques : a prospective randomized study. J Should Elb Surg 19:251–257 CrossRef
- Wirth MA, Korvick DL, Basamania CJ, Toro F, Aufdemorte TB, Rockwood CA Jr (2001) Radiologic, mechanical, and histologic evaluation of 2 prosthesis designs in a canine model. J Shoulder Joint Surg 10:140–148 CrossRef
- Matsen FA, Clinton J, Lynch J, Bertelsen A, Richardson ML (2008) Glenoid component failure in total shoulder arthroplasty. J Bone Joint Surg Am 90:885–896 CrossRef
- Lazarus MD, Jensen KL, Southworth C, Matsen FA III (2002) The radiographic evaluation of keeled and pegged glenoid component insertion. J Bone Jt Surg Am 84:1174–1182
- Churchill RS, Zellmer C, Zimmers HJ, Ruggero R (2010) Clinical and radiographic analysis of a partially cemented glenoid implant: five-year minimum follow-up. J Should Elb Surg 19:1091–1097 CrossRef
- Groh GI (2010) Survival and radiographic analysis of a glenoid component with a cementless fluted central peg. J Should Elb Surg 19:1265–1268 CrossRef
- Arnold RM, High RR, Grosshans KT, Walker CW, Fehringer EV (2011) Bone presence between the central peg’s radial fins of a partially cemented pegged all poly glenoid component suggest few radiolucencies. J Should Elb Surg 20:315–321 CrossRef
- Wirth MA, Loredo R, Garcia G, Rockwood CA, Southworth C, Iannotti JP (2012) Total shoulder arthroplasty with an all-polyethylene pegged bone-ingrowth glenoid component. J Bone Jt Surg Am 94:260–267 CrossRef
- Yian EH, Werner CM, Nyffler RW, Pfirrmann CW, Ramappa A, Sukthankar A et al (2005) Radiographic and computed tomography analysis of cemented pegged polyethylene glenoid components in total shoulder replacement. J Bone Jt Surg Am 87:1928–1936 CrossRef
- CT scan evaluation of glenoid component fixation: a prospective study of 27 minimally cemented shoulder arthroplasties
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
European Journal of Orthopaedic Surgery & Traumatology
Volume 23, Issue 5 , pp 521-525
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Shoulder arthroplasty
- Pegged glenoid component
- Bone ingrowth
- CT scan
- Industry Sectors