Total Shoulder Arthroplasty with an All-Polyethylene Pegged Bone-Ingrowth Glenoid Component

Wirth, Michael A.; Loredo, Rebecca A; Garcia, Glenn M.; Rockwood, Charles A.; Southworth, Carleton; Iannotti, Joseph P.

doi:10.2106/jbjs.j.01400

Cited by 113 publications

(72 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We found an overall decrease in the rate of instability (1% [35 of 3,360 shoulders 9,20,21, 32,40,41,43,52,55,62,68,71,72,74,[76][77][78]83,87,103,106,108,[112][113][114][115][116]118,119,[121][122][123][124] ] in the current study compared with 4.9% [124 of 2,540 shoulders] in the earlier study 1 ). Component malposition (nonanatomic humeral and glenoid retroversion) and rotator cuff deficiency may lead to adverse kinematics of the glenohumeral joint, subsequent instability, edge loading of the glenoid component, and premature loosening 1,133 .…”

Section: Anatomic Tsacontrasting

confidence: 43%

See 1 more Smart Citation

Complications of Shoulder Arthroplasty

Bohsali

Bois

Wirth³

2017

The Journal of Bone and Joint Surgery

285

199

View full text Add to dashboard Cite

d The most common complications after reverse shoulder arthroplasty in order of decreasing frequency included instability, periprosthetic fracture, infection, component loosening, neural injury, acromial and/or scapular spine fracture, hematoma, deltoid injury, rotator cuff tear, and venous thromboembolism (VTE).d The most common complications after anatomic total shoulder arthroplasty (TSA) in order of decreasing frequency were component loosening, glenoid wear, instability, rotator cuff tear, periprosthetic fracture, neural injury, infection, hematoma, deltoid injury, and VTE.d Glenoid component wear and loosening remain a common cause of failure after anatomic TSA, despite advances in surgical technique and implant design.d Diagnostic confirmation of infection after shoulder arthroplasty remains a challenge. In the setting of a painful and stiff shoulder after arthroplasty, the surgeon should have a heightened suspicion for infection. Inflammatory markers may be normal, radiographs may be inconclusive, and prosthetic joint aspiration may be negative for a causative organism.Disclosure: The authors indicated that no external funding was received for any aspect of this work. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked "yes" to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work and "yes" to indicate that the author had a patent and/or copyright, planned, pending, or issued, broadly relevant to this work. 99:256-69 d http://dx.doi.org/10.2106/JBJS.16.00935 frequency) included instability, periprosthetic fracture, infection, component loosening, neural injury, acromial and/or scapular spine fracture, hematoma, deltoid injury, rotator cuff tear, and venous thromboembolism (VTE)The most common complications after anatomic TSA (in order of decreasing frequency) were component loosening, glenoid wear, instability, rotator cuff tear, periprosthetic fracture, neural injury, infection, hematoma, deltoid injury, and VTE (

show abstract

Section: Anatomic Tsacontrasting

confidence: 43%

“…Efficacy regarding these surgical techniques remains largely unproven.loosening made up a majority of these events (217 [82%] of 264 shoulders) . Glenoid implant failure comprised 37.7%(130) of 345 complications after TSA 9,20,21,32,40,41,43,52,55,62,68,71,72,74,[76][77][78]83,87,103,106,108,[112][113][114][115][116]118,119,[121][122][123][124] …”

mentioning

confidence: 99%

Complications of Shoulder Arthroplasty

Bohsali

Bois

Wirth³

2017

The Journal of Bone and Joint Surgery

285

199

View full text Add to dashboard Cite

show abstract

“…The presence of bone between the flanges of the central peg of the glenoid was demonstrated in 32 of the 35 shoulders. More recently, Wirth et al [12] analyzed clinical and radiographic outcomes of 44 shoulder replacements with a minimum of 2 years of follow-up. Twenty shoulders had perfect seating and radiolucency grades, 30 had increased radiodensity between the flanges of the central peg, and three demonstrated osteolysis.…”

Section: Discussionmentioning

confidence: 99%

CT scan evaluation of glenoid component fixation: a prospective study of 27 minimally cemented shoulder arthroplasties

Vidil

Valenti

Guichoux

et al. 2012

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

BackgroundGlenoid 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 methodsWe 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.ResultsImprovement 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.Discussion/conclusionLong-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.

show abstract

“…The essential elements of our surgical techniques were described in detail previously [36,39,42,43]: a deltopectoral approach, subscapularis peel, retention of the long head tendon of the biceps unless it was damaged, humeral head cut in 30 o retroversion, conservative glenoid reaming without specific attempt to normalize glenoid version, use of the Anchor Peg Glenoid prosthesis (DePuy Synthes) [63] in total shoulder arthroplasties, and fixation of the humeral component using impaction autografting [6,24]. Any tendency for excessive posterior translation at the time of surgery was managed with anteriorly eccentric humeral head components and/or rotator interval plication [29,36,39,42,43].…”

Section: Description Of Experiment Treatment or Surgerymentioning

confidence: 99%

What Factors are Predictive of Patient-reported Outcomes? A Prospective Study of 337 Shoulder Arthroplasties

Matsen

Russ

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Although shoulder arthroplasties generally are effective in improving patients' comfort and function, the results are variable for reasons that are not well understood. Questions/Purposes We posed two questions: (1) What factors are associated with better 2-year outcomes after shoulder arthroplasty? (2) What are the sensitivities, specificities, and positive and negative predictive values of a multivariate predictive model for better outcome? Methods Three hundred thirty-nine patients having a shoulder arthroplasty (hemiarthroplasty, arthroplasty for cuff tear arthropathy, ream and run arthroplasty, total shoulder or reverse total shoulder arthroplasty) between August 24, 2010 and December 31, 2012 consented to participate in this prospective study. Two patients were excluded because they were missing baseline variables. Forty-three patients were missing 2-year data. Univariate and multivariate analyses determined the relationship of baseline patient, shoulder, and surgical characteristics to a ''better'' outcome, defined as an improvement of at least 30% of the maximal possible improvement in the Simple Shoulder Test. The results were used to develop a predictive model, the accuracy of which was tested using a 10-fold cross-validation. Results After controlling for potentially relevant confounding variables, the multivariate analysis showed that the factors significantly associated with better outcomes were American Society of Anesthesiologists Class I (odds ratio [OR], 1.94; 95% CI, 1.03-3.65; p = 0.041), shoulder problem not related to work (OR, 5.36; 95% CI, 2.15-13.37; p \ 0.001), lower baseline Simple Shoulder Test score (OR, 1.32; 95% CI, 1.23-1.42; p \ 0.001), no prior shoulder surgery (OR, 1.79; 95% CI, 1.18-2.70; p = 0.006), humeral head not superiorly displaced on the AP radiograph (OR, 2.14; 95% CI, 1.15-4.02; p = Each author certifies that his or her institution approved the human protocol for this investigation that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. OR, 4.47; 95% CI,; p \ 0.001). Neither preoperative glenoid version nor posterior decentering of the humeral head on the glenoid were associated with the outcomes. The model predictive of a better result was driven mainly by the six factors listed above. The area under the receiver operating characteristic curve generated from the crossvalidated enhanced predictive model was 0.79 (generally values of 0.7 to 0.8 are considered fair and values of 0.8 to 0.9 are considered good). The false-positive fraction and the true-positive fraction depended on the cutoff probability selected (ie, the selected probability above which the prediction would be classified as a better outcome). A cutoff probability of 0.68 yielded the best performance of the model with cross-validation predictions of better outcomes for 236 patients (80%) and worse outcomes for 58 patients (20%); sensitivity of 91% (95% CI, 88%-95%); specificity of ...

show abstract

Total Shoulder Arthroplasty with an All-Polyethylene Pegged Bone-Ingrowth Glenoid Component

Abstract: Total shoulder arthroplasty with a minimally cemented, all-polyethylene, pegged glenoid implant can yield stable and durable fixation at short to medium-term follow-up (mean, four years).

Cited by 113 publications

References 24 publications

Complications of Shoulder Arthroplasty

Complications of Shoulder Arthroplasty

CT scan evaluation of glenoid component fixation: a prospective study of 27 minimally cemented shoulder arthroplasties

What Factors are Predictive of Patient-reported Outcomes? A Prospective Study of 337 Shoulder Arthroplasties

Contact Info

Product

Resources

About