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. 2020 Dec;12(1 Suppl):4-10.
doi: 10.1177/1758573218789339. Epub 2018 Aug 6.

Short-term rates of radiolucency after primary total shoulder arthroplasty using a cementless metal-backed pegged polyethylene glenoid

Khalid Al-Hourani  1 , James R Smith  1 , Mark A Crowther  2 , Partha Sarangi  1 , Philip A McCann  1
Affiliations

Short-term rates of radiolucency after primary total shoulder arthroplasty using a cementless metal-backed pegged polyethylene glenoid

Khalid Al-Hourani et al. Shoulder Elbow. 2020 Dec.

Abstract

Background: Total shoulder arthroplasty has shown good clinical efficacy in treating primary and secondary degenerative conditions of the glenohumeral joint. Glenoid loosening, however, remains the commonest cause of failure. The purpose of this study was to investigate the rate of radiographic periprosthetic lucency associated with the use of an uncemented, pegged, metal-backed polyethylene glenoid component.

Materials and methods: A retrospective, single-centre study using the Epoca (Synthes, Paoli, Pennsylvania) metal-backed glenoid component. Operations were performed by two experienced consultant upper limb surgeons. Radiographs were analysed for immediate post-operative component seating and periprosthetic radiolucent lines at predefined regular post-operative intervals. Intra- and inter-observer reliability was assessed to improve validity of results.

Results: Mean age and follow-up was 72 (48-91) years and 2.5 years (2-5), respectively. Main indications for total shoulder arthroplasty were primary osteoarthritis, rheumatoid arthritis, revision for failed hemi-arthroplasty and acute fracture. Ninety-six per cent of components were completely seated post-operatively. Fifty-four (95%) of the 57 shoulders had no periprosthetic radiolucent lines at most recent follow-up. Complete post-operative glenoid seating was significantly associated with the absence of later periprosthetic radiolucency (p < 0.01).

Conclusion: This study reports low early radiolucency rates with the pegged, uncemented, metal-backed polyethylene glenoid prosthesis used. Excellent post-operative glenoid seating is associated with a significantly lower rate of radiolucency. Longer follow-up data are required to confirm these early promising results.Level of evidence: Therapeutic, level IV.

Keywords: arthroplasty; glenoid; lucency; metal backed; pegged; radiolucency; shoulder.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Bristol radiolucency zones. Source: Image modified from Epoca Shoulder Arthroplasty System – Stem and Glenoid (Technique Guide).
See this image and copyright information in PMC

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