An uncemented metal-backed glenoid component in total shoulder arthroplasty for osteoarthritis: factors affecting survival and outcome

Abstract

BackgroundThe reported survivorship of total shoulder replacement (TSR) is variable. This is probably related to implant design. We report the outcome and survivorship of the uncemented glenoid in patients with osteoarthritis receiving a TSR with an intact or repairable rotator cuff at surgery. MethodsThirty-two consecutive patients were analysed after TSR using a screw-fixed porous coated metal-back glenoid performed by a single surgeon, with a minimum follow-up of fiveyears. Thirty-three TSRs in 32 patients (19 women) with a mean age of 67years were analysed, two of whom died before fiveyears of follow-up. Thirty patients (31 shoulders) were monitored for a mean of 95months (60–173months). ResultsThe Constant score improved by 22 points (p<0.001). The only significant predictor of outcome on logistic regression analysis was the preoperative Constant score, with better scores resulting in a lesser improvement at last follow-up (p<0.0001). Implant survivorship at tenyears was 93%. Three were revisions: two for polyethylene wear (both at sixyears) but with a well-fixed glenoid, and another for loosening of the glenoid at 11years postoperatively. Univariate analysis identified that younger age (56year vs. 68years, p=0.03) and a higher combined preoperative Constant score (35.7 vs. 21.5, p=0.03) were both predictors of failure. ConclusionThe uncemented glenoid performs well in the medium term for osteoarthritis of the shoulder in older patients, giving improved and sustained functional outcome. Age and preoperative level of function are predictors of outcome and survival.