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Long-term survival of the glenoid components in total shoulder replacement for arthritis

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Abstract

Purpose

Aseptic glenoid component loosening remains a common problem in total shoulder arthroplasty (TSA). This study presents long-term prospective follow-up after implantation of a glenoid component using the “cancellous compaction technique” and its effect on clinical outcome and presence and progression of radiolucent lines (RLLs).

Method

Thirty-nine TSAs were performed for primary osteoarthritis by one surgeon using the same technique. For the glenoid side, a keeled, polyethylene, convex-backed component was implanted using the “cancellous compaction technique” consisting of minimal reaming, compaction bone grafting of the glenoid and minimal addition of cement. Postoperative clinical outcome was analysed using Constant scores and patient’s subjective evaluation. Independent observers evaluated postoperative X-rays for radiolucent lines (RLL) around the base plate and keel.

Results

At an average follow-up of 8.5 years (range 4.7–12.5), the Constant score improved from 33.5 to 73.0 points (P < 0.0001). Active anterior elevation improved from an average 95 ° to 140° (P < 0.0001), and active external rotation improved from 20° to 45° (P < 0.0001). Pain score improved from 3.1 to 13.6 (P < 0.0001). Radiologically, the RLL score increased from 1.09 (range, 0–3) postoperative to 5.7 (range, 0–18) (P < 0.0001) at final follow-up. The occurrence of definite radiological glenoid loosening was 15.5 %. Constant scores deteriorated with the progression of RLLs (P = 0.006). The rate of revision surgery for glenoid loosening was 2.5 %.

Conclusions

This study showed highly satisfactory clinical outcomes and low rates of revision for glenoid loosening using a bone-saving compaction technique for implantation of an all-polyethylene glenoid component.

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Acknowledgments

The authors would like to acknowledge the three independent observers—Gilles Walch, MD, Vittorio Bellotti, MD and Olivier Verborgt, MD, who is one of the authors of the present study, and for the contribution to the evaluation of the radiology follow-up.

Conflict of interest

D. F. Gazielly and M. M. Scarlat have no conflict of interest to declare.

Author information

Authors and Affiliations

  1. The Shoulder Unit, Clinique Genollier, Genollier, Switzerland

    Dominique F. Gazielly

  2. Clinique Chirurgicale St Michel, Toulon, France

    Marius M. Scarlat

  3. AZ Monica & University Hospital Antwerp, Antwerp, Belgium

    Olivier Verborgt

Authors
  1. Dominique F. Gazielly
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  2. Marius M. Scarlat
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  3. Olivier Verborgt
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Corresponding author

Correspondence to Marius M. Scarlat.

Additional information

Dr Verborgt is a consultant for Zimmer, Smith & Nephew and receives royalties from Acco Medical who is a book publisher.

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Gazielly, D.F., Scarlat, M.M. & Verborgt, O. Long-term survival of the glenoid components in total shoulder replacement for arthritis. International Orthopaedics (SICOT) 39, 285–289 (2015). https://doi.org/10.1007/s00264-014-2637-y

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  • DOI: https://doi.org/10.1007/s00264-014-2637-y

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