Fully uncemented glenoid component in total shoulder arthroplasty

Abstract

Loosening of the glenoid component remains the most common problem in total shoulder arthroplasty. It has been described that the round-backed, all-polyethylene components with cemented peg fixation perform better biomechanically and clinically than flat-backed, metal-backed, or keeled components. However, side effects of cementing have been described. We hypothesized that cementing of a specific type of all-polyethylene glenoid component with 3 peripheral pegs and 1 central anchor peg is not necessary to obtain good clinical and radiologic results. Thirty-four shoulders (34 patients), with a mean follow-up of 28.3 months, were evaluated clinically with the Constant-Murley score and the SF-12 Health Survey score. The fixation of the glenoid component was evaluated with computed tomography scan. The Constant-Murley score increased from 40.2 points (range, 13-73 points) preoperatively to 72points (range, 54-93 points) postoperatively. The SF-12 Physical Component Summary score was 45, and the SF-12 Mental Component Summary score was 50. No signs of loosening were seen around the pegs or glenoid in 30 shoulders. Signs of loosening were seen around the central anchor peg and the peripheral pegs in 4 shoulders. There was no statistical difference between the clinical outcome of patients with and without signs of loosening. The clinical and radiologic evaluation of an uncemented all-polyethylene glenoid is promising, with good clinical results and with no signs of loosening in 88% of the patients on computed tomography scans.