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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

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Abstract

Aim of the study

To assess the clinical and computed tomography (CT) outcomes of shoulder replacement with a novel bone ingrowth all-polyethylene glenoid component (APGC).

Methods

Twenty-eight patients (30 shoulders) with osteoarthritis, mean age 62.3 years (range, 45–75), were implanted with the novel component between 2011 and 2013. Patients were evaluated by active range of motion (ROM), Constant-Murley score (CMS), simple shoulder test (SST), X-rays, and multidetector CT at two months and at a mean follow-up of 31 months (range, 24–39). Early and late follow-up CT scans were available for 21/30 shoulders.

Results

Median ROM increased from 105 to 160° for anterior elevation, from 100 to 160° for lateral elevation, from 20 to 40° for external rotation, and from 2 to 10 points for internal rotation (all p < 0.001). CMS rose from 30 to 80.5 points and SST from 2.5 to 11 (both p < 0.0001). None of the glenoid components migrated. Progressive radiolucency was seen in 28/30 shoulders. There was a strong correlation between greater bone ingrowth (median Arnold score: 7) and lower radiolucency score (median Yian score: 2) at the last follow-up (p < 0.001). Osteolysis around the central peg was seen in two shoulders. There was no correlation between clinical scores and CT findings (p >0.05).

Discussion

The partially cemented glenoid component for TSR assessed in this study resulted in satisfactory shoulder function at an early follow-up. The glenoid prosthesis was stable, with few radiolucent lines and good central peg bone ingrowth.

Conclusions

The satisfactory bone ingrowth documented on CT is encouraging and supports the use of the new prosthesis. Long-term follow-up studies can confirm if this device represents a rational alternative to fully cemented polyethylene glenoids.

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References

  1. Papadonikolakis A, Neradilek MB, Matsen FA (2013) Failure of the glenoid component in anatomic total shoulder arthroplasty: a systematic review of the English-language literature between 2006 and 2012. J Bone Joint Surg Am 95:2205–12. doi:10.2106/JBJS.L.00552

    Article  PubMed  Google Scholar 

  2. Papadonikolakis A, Matsen FA (2014) Metal-Backed Glenoid Components Have a Higher Rate of Failure and Fail by backed glenoid components have a higher rate of failure and fail by different modes in comparison with all-polyethylene components: a systematic review. J Bone Joint Surg Am 96:1041–1047. doi:10.2106/JBJS.M.00674

    Article  PubMed  Google Scholar 

  3. Sayegh ET, Mascarenhas R, Chalmers PN et al (2015) Surgical treatment options for glenohumeral arthritis in young patients: a systematic review and meta-analysis. Arthroscopy 31:1156–1166.e8. doi:10.1016/j.arthro.2014.11.012

    Article  PubMed  Google Scholar 

  4. Wiater JM, Fabing MH (2009) Shoulder arthroplasty: prosthetic options and indications. J Am Acad Orthop Surg 17:415–25

    Article  PubMed  Google Scholar 

  5. Merolla G, Campi F, Paladini P et al (2009) Correlation between radiographic risk for glenoid component loosening and clinical scores in shoulder arthroplasty. Chir Organi Mov 93(Suppl 1):S29–34. doi:10.1007/s12306-009-0008-4

    PubMed  Google Scholar 

  6. Edwards TB, Labriola JE, Stanley RJ et al (2010) Radiographic comparison of pegged and keeled glenoid components using modern cementing techniques: a prospective randomized study. J Shoulder Elb Surg 19:251–7. doi:10.1016/j.jse.2009.10.013

    Article  Google Scholar 

  7. Wirth MA, Loredo R, Garcia G et al (2012) Total shoulder arthroplasty with an all-polyethylene pegged bone-ingrowth glenoid component: a clinical and radiographic outcome study. J Bone Joint Surg Am 94:260–7. doi:10.2106/JBJS.J.01400

    Article  PubMed  Google Scholar 

  8. Raiss P, Sowa B, Bruckner T et al (2012) Pressurisation leads to better cement penetration into the glenoid bone: a cadaveric study. J Bone Joint Surg Br Vol 94:671–7. doi:10.1302/0301-620X.94B5.28831

    Article  CAS  Google Scholar 

  9. Budge MD, Kurdziel MD, Baker KC, Wiater JM (2013) A biomechanical analysis of initial fixation options for porous-tantalum-backed glenoid components. J Shoulder Elb Surg 22:709–15. doi:10.1016/j.jse.2012.07.001

    Article  Google Scholar 

  10. Jones AC, Arns CH, Sheppard AP et al (2007) Assessment of bone ingrowth into porous biomaterials using MICRO-CT. Biomaterials 28:2491–504. doi:10.1016/j.biomaterials.2007.01.046

    Article  CAS  PubMed  Google Scholar 

  11. Wirth MA, Korvick DL, Basamania CJ et al (2001) Radiologic, mechanical, and histologic evaluation of 2 glenoid prosthesis designs in a canine model. J Shoulder Elb Surg 10:140–8. doi:10.1067/mse.2001.112021

    Article  CAS  Google Scholar 

  12. Nuttall D, Haines JF, Trail IA (2012) The early migration of a partially cemented fluted pegged glenoid component using radiostereometric analysis. J Shoulder Elb Surg 21:1191–6. doi:10.1016/j.jse.2011.07.028

    Article  Google Scholar 

  13. Arnold RM, High RR, Grosshans KT et al (2011) Bone presence between the central peg’s radial fins of a partially cemented pegged all poly glenoid component suggest few radiolucencies. J Shoulder Elb Surg 20:315–21. doi:10.1016/j.jse.2010.05.025

    Article  Google Scholar 

  14. Noyes MP, Meccia B, Spencer EE (2015) Five- to ten-year follow-up with a partially cemented all-polyethylene bone-ingrowth glenoid component. J Shoulder Elb Surg 24:1458–62. doi:10.1016/j.jse.2015.02.018

    Article  Google Scholar 

  15. Groh GI (2010) Survival and radiographic analysis of a glenoid component with a cementless fluted central peg. J Shoulder Elb Surg 19:1265–8. doi:10.1016/j.jse.2010.03.012

    Article  Google Scholar 

  16. Vidil A, Valenti P, Guichoux F, Barthas JH (2013) CT scan evaluation of glenoid component fixation: a prospective study of 27 minimally cemented shoulder arthroplasties. Eur J Orthop Surg Traumatol 23:521–5. doi:10.1007/s00590-012-1126-5

    Article  CAS  PubMed  Google Scholar 

  17. Nuttall D, Haines JF, Trail IA (2011) The early migration of a partially cemented fluted pegged glenoid component using radiostereometric analysis. J Shoulder Elb Surg 1–6. doi:10.1016/j.jse.2011.07.028

  18. Samilson RL, Prieto V (1983) Dislocation arthropathy of the shoulder. J Bone Joint Surg Am 65:456–60

    CAS  PubMed  Google Scholar 

  19. Gerber C (1992) Latissimus dorsi transfer for the treatment of irreparable tears of the rotator cuff. Clin Orthop Relat Res 152–60

  20. Walch G, Badet R, Boulahia A, Khoury A (1999) Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplast 14:756–60

    Article  CAS  Google Scholar 

  21. Merolla G, Amore B, Paladini P et al (2014) Computed tomography quantification of bone density adjacent to cemented pegged polyethylene glenoid components in shoulder arthroplasty. Eur J Orthop Surg Traumatol 24:753–61. doi:10.1007/s00590-013-1368-x

    Article  PubMed  Google Scholar 

  22. Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 160–4

  23. Godfrey J, Hamman R, Lowenstein S et al (2006) Reliability, validity, and responsiveness of the simple shoulder test: psychometric properties by age and injury type. J Shoulder Elb Surg 16:260–7. doi:10.1016/j.jse.2006.07.003

    Article  Google Scholar 

  24. Yian EH, Werner CML, Nyffeler RW et al (2005) Radiographic and computed tomography analysis of cemented pegged polyethylene glenoid components in total shoulder replacement. J Bone Joint Surg Am 87:1928–36. doi:10.2106/JBJS.D.02675

    Article  PubMed  Google Scholar 

  25. Friedman RJ, Hawthorne KB, Genez BM (1992) The use of computerized tomography in the measurement of glenoid version. J Bone Joint Surg Am 74:1032–7

    CAS  PubMed  Google Scholar 

  26. Bohsali KI, Wirth MA, Rockwood CA (2006) Complications of total shoulder arthroplasty. J Bone Joint Surg Am 88:2279–92. doi:10.2106/JBJS.F.00125

    Article  PubMed  Google Scholar 

  27. Merolla G, Chin P, Sasyniuk TM, Porcellini G (2016) Total shoulder arthroplasty with a second- generation tantalum trabecular metal-backed glenoid component. 98:1–6. doi:10.1302/0301-620X.98B1.36620

  28. Parks DL, Casagrande DJ, Schrumpf MA, et al. (2015) Radiographic and clinical outcomes of total shoulder arthroplasty with an all-polyethylene pegged bone ingrowth glenoid component : prospective short- to medium-term follow-up. J Shoulder and Elb Surg 1–10. doi:10.1016/j.jse.2015.07.008

  29. Gulotta LV, Chambers KL, Warren RF et al (2015) No Differences in Early Results of a Hybrid Glenoid Compared With a Pegged Implant. Clin Orthop Relat Res 473:3918–3924. doi:10.1007/s11999-015-4558-5

    Article  PubMed  Google Scholar 

  30. Mileti J, Boardman ND, Sperling JW et al (2004) Radiographic analysis of polyethylene glenoid components using modern cementing techniques. J Shoulder Elb Surg 13:492–498. doi:10.1016/j.jse.2004.03.001

    Article  Google Scholar 

  31. Nagels J, Valstar ER, Stokdijk M, Rozing PM (2002) Patterns of loosening of the glenoid component. J Bone Joint Surg Br Vol 84:83–7

    Article  CAS  Google Scholar 

  32. Churchill RS, Boorman RS, Fehringer E V, Matsen FA (2004) Glenoid cementing may generate sufficient heat to endanger the surrounding bone. Clin Orthop Relat Res 76–9

  33. Lucas RM, Hsu JE, Whitney IJ et al (2016) Loose glenoid components in revision shoulder arthroplasty: is there an association with positive cultures? J Shoulder Elb Surg. doi:10.1016/j.jse.2015.12.026

    Google Scholar 

  34. Levy O, Iyer S, Atoun E et al (2013) Propionibacterium acnes: an underestimated etiology in the pathogenesis of osteoarthritis? J Shoulder Elb Surg 22:505–11. doi:10.1016/j.jse.2012.07.007

    Article  Google Scholar 

  35. Iannotti JP, Weiner S, Rodriguez E et al (2015) Three-dimensional imaging and templating improve glenoid implant positioning. J Bone Joint Surg Am 97:651–8. doi:10.2106/JBJS.N.00493

    Article  PubMed  Google Scholar 

  36. Dilisio MF, May NR, Vincent SA et al (2015) The association of incomplete glenoid component seating and periprosthetic glenoid radiolucencies after total shoulder arthroplasty. J Shoulder Elb Surg 101:1–6. doi:10.1016/j.jse.2015.08.005

    Google Scholar 

  37. Farron A, Terrier A, Büchler P (2006) Risks of loosening of a prosthetic glenoid implanted in retroversion. J Shoulder Elb Surg 15:521–6. doi:10.1016/j.jse.2005.10.003

    Article  Google Scholar 

  38. Matsen FA 3rd (2015) The ream and run: not for every patient, every surgeon or every problem. Int Orthop 39:255–61. doi:10.1007/s00264-014-2641-2

    Article  PubMed  Google Scholar 

  39. Gazielly DF, Scarlat MM, Verborgt O (2015) Long-term survival of teh glenoid components in total shoulder replacement for osteoarthritis. Int Orthop 39:285–9

    Article  PubMed  Google Scholar 

  40. Schnetzke M, Coda S, Walch G, Loew M (2015) Clinical and radiological results of a cementless short stem shoulder prostheses at minimum follow-up of two years. Int Orthop 39:1351–7

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Shoulder and Elbow Unit, D. Cervesi Hospital, Via L.V. Beethoven 5, Cattolica (RN), 47841, Italy

    Giovanni Merolla, Giovanni Ciaramella, Paolo Paladini & Giuseppe Porcellini

  2. Research and Innovation Department, AUSL della Romagna, Rimini, Italy

    Elisabetta Fabbri

  3. Centre Orthopédique Santy, Lyon, France

    Gilles Walch

Authors
  1. Giovanni Merolla
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  2. Giovanni Ciaramella
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  3. Elisabetta Fabbri
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  4. Gilles Walch
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  5. Paolo Paladini
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  6. Giuseppe Porcellini
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Correspondence to Giovanni Merolla.

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Merolla, G., Ciaramella, G., Fabbri, E. et al. 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. International Orthopaedics (SICOT) 40, 2355–2363 (2016). https://doi.org/10.1007/s00264-016-3255-7

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  • DOI: https://doi.org/10.1007/s00264-016-3255-7

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