Does Postoperative Glenoid Retroversion Affect the 2-Year Clinical and Radiographic Outcomes for Total Shoulder Arthroplasty?

Service, Benjamin C.; Hsu, Jason E.; Somerson, Jeremy S.; Russ, Stacy M.; Matsen, Frederick A.

doi:10.1007/s11999-017-5433-3

Cited by 54 publications

(20 citation statements)

References 66 publications

(111 reference statements)

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“…A total of 25 studies were noncomparative. Of these studies, 9 examined keeled glenoid fixations9, 12, 15, 19, 23, 31, 50, 51, 54 and 16 examined pegged glenoid fixations5, 7, 14, 25, 26, 27, 28, 29, 35, 36, 38, 39, 42, 45, 49, 53 (Table I). Among these studies, 10 reported ASES scores, 16 reported Constant scores, 19 reported radiolucency rates, and 19 reported revision rates.…”

Section: Resultsmentioning

confidence: 99%

A comparison of pegged vs. keeled glenoid components regarding functional and radiographic outcomes in anatomic total shoulder arthroplasty: a systematic review and meta-analysis

et al. 2019

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BackgroundThe number of total shoulder arthroplasties (TSAs) performed is increasing annually, with a continued effort to improve outcomes using new techniques and materials. In anatomic TSAs, the main options for glenoid fixation currently involve keeled or pegged components. The aim of this review was to determine which fixation option provides optimal long-term functional outcomes with decreased rates of revision surgery and radiolucency.MethodsThe MEDLINE, Embase, PubMed, and Cochrane databases were searched from 2007 to July 10, 2017, for all articles that examined TSAs using either pegged or keeled glenoid fixations. All studies were screened in duplicate for eligibility. Two separate analyses were completed examining noncomparative and comparative studies independently.ResultsA total of 7 comparative studies and 25 noncomparative studies were included in the final analysis. Included in the analysis were 4 randomized (level I) studies, 1 level II study, 8 level III studies, and 19 level IV studies. Meta-analysis of the comparative studies demonstrated a higher rate of revision surgery with keeled fixations compared with pegged fixations (odds ratio, 6.22; 95% confidence interval [CI], 1.38-28.1; P = .02). No significant difference was found with respect to functional outcomes, such as the American Shoulder and Elbow Surgeons score (mean difference, 9.54; 95% CI, –8.25 to 27.34; P = .29) and Constant score (mean difference, 5.31; 95% CI, –12.28 to 22.89; P = .55), as well as radiolucency rates (odds ratio, 1.89; 95% CI, 0.56−6.39; P = .30).ConclusionPegged glenoid fixation may result in a decreased risk of revision TSAs, but no significant differences in patient-reported outcomes have been identified to date.

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Section: Resultsmentioning

confidence: 99%

A comparison of pegged vs. keeled glenoid components regarding functional and radiographic outcomes in anatomic total shoulder arthroplasty: a systematic review and meta-analysis

et al. 2019

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“…There could be bias between the study group and patients lost to follow-up, but our follow-up rate is comparable to other studies. 16 , 31 Third, our mean follow-up is 4.2 years, though the TSA survival is expected to exceed 10 years. Longer follow-up is needed to provide more information on the relationship between radiographic measures, clinical outcomes, and implant longevity.…”

Section: Discussionmentioning

confidence: 96%

“…There was no significant difference between the 2 groups in outcomes at 2-year follow-up. 31 Recent reports using CT scans to evaluate preoperative glenoid retroversion have also shown no clinical differences. 4 We observed that the change in retroversion was not associated with better clinical outcomes and that final clinical outcomes were not dependent on postoperative glenoid retroversion.…”

Section: Discussionmentioning

confidence: 99%

“…Standardized preoperative and postoperative axillary radiographs were collected within a year before and after surgery. Glenoid retroversion was evaluated using the methodology of Service et al, 31 and humeral head subluxation was evaluated according to Walch et al 38 on preoperative ( Fig. 1 ) and postoperative ( Fig.…”

Section: Methodsmentioning

confidence: 99%

“…Although cadaveric biomechanical studies show that glenoid component retroversion and eccentric humeral head loading lead to increased contact forces, excessive glenoid component wear, and glenoid component loosening, 6 , 26 , 32 , 36 the clinical outcomes following TSA with retroverted glenoids are controversial. 11 , 27 , 31 , 38 It is still questionable how correction of glenoid retroversion at the time of TSA influences postoperative outcomes.…”

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confidence: 99%

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Do glenoid retroversion and humeral subluxation affect outcomes following total shoulder arthroplasty?

Benjamin¹,

Xiao²,

Salesky³

et al. 2020

JSES International

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Background Glenoid retroversion and humeral head subluxation have been suggested to lead to inferior outcomes after total shoulder arthroplasty (TSA). There are limited data to support this suggestion. We investigated whether preoperative glenoid retroversion and humeral head subluxation are associated with inferior outcomes after TSA and whether change of retroversion influences outcomes after TSA. Methods Patients undergoing TSA with minimum 2-year follow-up were included from a prospectively collected institutional shoulder arthroplasty database. Retroversion and humeral head subluxation before and after surgery were measured on axillary radiographs. Postoperative radiographs were -evaluated for glenoid component loosening and compared between groups. Spearman correlations were determined between retroversion measurements and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) scores. Patients were analyzed in groups based on retroversion and humeral head subluxation. Results There were 113 patients (50% follow-up rate) evaluated at 4.2 years postoperatively. The mean preoperative retroversion (15.3° ± 7.7°) was significantly higher than postoperative retroversion (10.0° ± 6.8°; P < .0001). There was no correlation between postoperative glenoid version or humeral head subluxation and ASES scores. For patients with preoperative retroversion of >15°, there was no difference in outcome scores based on postoperative retroversion. There were no differences in preoperative or postoperative version for patients with or without glenoid lucencies. Discussion We observed no significant relationship between postoperative glenoid retroversion or humeral head subluxation and clinical outcomes in patients following TSA. For patients with preoperative retroversion >15°, change of retroversion during TSA had no impact on their clinical outcomes at short-term follow-up.

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Management of the Failed Anatomic Total Shoulder Arthroplasty

Rapp

Shields

et al. 2019

Complex and Revision Shoulder Arthroplasty

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Does Postoperative Glenoid Retroversion Affect the 2-Year Clinical and Radiographic Outcomes for Total Shoulder Arthroplasty?

Abstract: Level III, therapeutic study.

Cited by 54 publications

References 66 publications

A comparison of pegged vs. keeled glenoid components regarding functional and radiographic outcomes in anatomic total shoulder arthroplasty: a systematic review and meta-analysis

A comparison of pegged vs. keeled glenoid components regarding functional and radiographic outcomes in anatomic total shoulder arthroplasty: a systematic review and meta-analysis

Do glenoid retroversion and humeral subluxation affect outcomes following total shoulder arthroplasty?

Management of the Failed Anatomic Total Shoulder Arthroplasty

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