Radiographic comparison of pegged and keeled glenoid components

Gartsman, Gary M.; Elkousy, Hussein; Warnock, K. Mathew; Edwards, T. Bradley; O’Connor, Daniel P.

doi:10.1016/j.jse.2004.09.006

Cited by 124 publications

(64 citation statements)

References 34 publications

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“…In these 171 replacements, 78 used a pegged glenoid component whereas 93 used a keeled implant. Several studies have shown differences in radiographic and biomechanical behavior of glenoid components fixed with a keel versus those with pegs [5][6][7]13]. Other studies indicate differing designs of glenoids may have different radiographic and clinical performances affecting the fixation of the humeral component [1,2,21].…”

Section: Patients and Materialsmentioning

confidence: 99%

Radiographic Stability of Ingrowth Humeral Stems in Total Shoulder Arthroplasty

Throckmorton

Zarkadas

Sperling

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Cemented and uncemented stem types are available for TSA. An early uncemented stem designed for bone ingrowth had radiographic loosening of approximately 10% at intermediate followup (mean 4.6 years). Subsequent stem modifications included circumferential metaphyseal porous coating to enhance ingrowth and reduce loosening rates. Questions/purposes We asked whether the radiographic loosening rates would be lower after this design modification and whether the pain score and ROM would be improved. Patients and MethodsWe reviewed the medical records and radiographs of 76 patients undergoing primary TSA with circumferential metaphyseal porous-coated stems for osteoarthritis between 1995 and 2005. All patients had a complete standardized series of radiographs preoperatively, postoperatively, and at final followup. Humeral stems were evaluated for any radiolucent lines by zone, progression of lucencies, and shift in component position.The minimum radiographic followup was 25 months (average, 52 months; range, 25-90 months).

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Section: Patients and Materialsmentioning

confidence: 99%

Radiographic Stability of Ingrowth Humeral Stems in Total Shoulder Arthroplasty

Throckmorton

Zarkadas

Sperling

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Although a small number of clinical studies of cemented TSA have shown no difference in micromotion or radiolucency between pegged and keeled glenoid components, 5,17 a recent review by Vavken and colleagues, 3 along with numerous other studies, 4,8,16,[23][24][25] showed that keeled glenoid components are inferior to pegged components in terms of fixation and patient outcomes. These findings are consistent with our study based on both the RSA and patient-reported outcome measures data.…”

Section: Discussionmentioning

confidence: 99%

“…7 Clinical studies have found that keeled components are more frequently unsupported at their posterior rim 4 and are associated with a greater incidence of radiolucent lines than pegged glenoid components. 8 Although these initial results suggest that pegged components provide greater stability than the keeled counterparts, a very recent review by Vavken and colleagues 3 has shown a significantly reduced risk of revision surgery with pegged glenoid components. Despite this finding, the authors reported that the difference in revision risk between pegged and keeled components was rather small and that there were no differences in the risk of radiolucency between component types.…”

mentioning

confidence: 99%

Radiostereometric analysis of keeled versus pegged glenoid components in total shoulder arthroplasty: a randomized feasibility study

Gascoyne

McRae

Parashin

et al. 2017

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Radiostereometric analysis of keeled versus pegged glenoid components in total shoulder arthroplasty: a randomized feasibility study Background: This study aimed to assess differences in the fixation and functional outcomes between pegged and keeled all-polyethylene glenoid components for standard total shoulder arthroplasty. Methods:Patients were randomized to receive a keeled or pegged all-polyethylene glenoid component. We used model-based radiostereometric analysis (RSA) to assess glenoid fixation and subjective outcome measures to assess patient function. Followup examinations were completed at 6 weeks and 6, 12 and 24 months after surgery. Modifications to the RSA surgical, imaging and analytical techniques were required throughout the study to improve the viability of the data.Results: Stymied enrolment resulted in only 16 patients being included in our analyses. The RSA data indicated statistically greater coronal plane migration in the keeled glenoid group than in the pegged group at 12 and 24 months. Functional outcome scores did not differ significantly between the groups at any follow-up. One patient with a keeled glenoid showed high component migration after 24 months and subsequently required revision surgery 7 years postoperatively.

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“…Fox et al [10] reported that glenoid component survivorship can be as much as 99% at 5 years using all-polyethelene cemented components . Because frank loosening is a relatively rare occurrence, others have evaluated the early development of radiolucent lines to help predict eventual glenoid loosening [3,6,8,14,19,20,24,30,33]. Although it might be debatable whether early radiolucencies portend future loosening, they generally are regarded as something to be avoided if possible.…”

Section: Discussionmentioning

confidence: 99%

No Differences in Early Results of a Hybrid Glenoid Compared With a Pegged Implant

Gulotta

Chambers

Warren

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Glenoid component loosening after total shoulder arthroplasty is one of the most common causes of failure. A hybrid glenoid that uses peripherally cemented pegs and a central press-fit post may improve implant longevity. Questions/purposes We asked, compared with polyethylene pegged glenoid implants, do hybrid glenoid implants with a titanium post provide (1) better ingrowth with fewer radiolucencies, (2) better outcome and pain scores, and (3) lower risk of complications and revisions? Methods Between 2009 and 2010, 126 patients underwent primary total shoulder arthroplasty for osteoarthritis.Patients were included in this retrospective study if they consented for inclusion in a shoulder arthroplasty registry, had complete baseline and 2-year data, and had complete radiographs. Eighty-three (67%) were available at an average followup of 3.2 years (range, 24-45 months). Forty received a conventional all-polyethylene pegged glenoid and 43 received a hybrid component. During the period in question, four of the participating surgeons used only one implant, and four used only the other; there was one highvolume surgeon in each of the study groups. Radiographs were taken at the 2-year followup and analyzed for radiolucent lines. CT scans were obtained randomly for 10 patients with hybrid glenoid implants to assess bone ongrowth. American Shoulder and Elbow Surgeons score, VAS score, complications and revisions were recorded. Results At final followup, radiolucent lines between the two study groups were not different (hybrid, 1.0 ± 0.4; pegged, 1.6 ± 0.3; mean difference, 0.6; 95% CI, 0.85-1.72; p = 0.323). Final VAS pain scores were not different (hybrid, 1.2 ± 0.2; pegged, 1.5 ± 0.3; p = 0.056). Change in American Shoulder and Elbow Surgeons scores were not different (hybrid, 33.7 ± 7.3; pegged, 35.5 ± 8.2; p = 0.283). There were no differences in complication risk (hybrid, one of 43 [2.3%]; pegged, three of 40 [7.5%]; relative risk, 2.3; 95% CI, 0.82-3.12; p = 0.061). Conclusions With the numbers available and at early followup, there were no differences between the hybrid and pegged glenoids in terms of fixation, functional outcome, pain scores, and complications. CT scans confirmed bone ongrowth on the porous titanium post in a small subcohort of patients. Further studies are needed to determine how this new implant will perform with time. Until then, its use should be initiated with caution.

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Radiographic comparison of pegged and keeled glenoid components

Cited by 124 publications

References 34 publications

Radiographic Stability of Ingrowth Humeral Stems in Total Shoulder Arthroplasty

Radiographic Stability of Ingrowth Humeral Stems in Total Shoulder Arthroplasty

Radiostereometric analysis of keeled versus pegged glenoid components in total shoulder arthroplasty: a randomized feasibility study

No Differences in Early Results of a Hybrid Glenoid Compared With a Pegged Implant

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