Clinical and Radiologic Outcomes After Anatomical Total Shoulder Replacement Using a Modular Metal-Backed Glenoid After a Mean Follow-Up of 5.7 Years

Overview

Journal J Clin Med

Specialty General Medicine

Date 2022 Oct 27

PMID 36294428

Authors

Emil Noschajew

Felix Rittenschober

Harald Kindermann

Reinhold Ortmaier

Affiliations

Soon will be listed here.

Abstract

Background: Glenoid wear is a common complication of anatomical total shoulder arthroplasty (aTSA) with a metal-backed glenoid (MBG), and the clinical and radiological results of historical implants are poor. The aim of this work was to evaluate the clinical and radiological results of 25 participants as well as the longevity after implantation of an anatomic shoulder prosthesis with a recent, modular cementless flat metal-backed glenoid component after a mean follow-up of 5.7 years. Methods: Clinically, the Simple Shoulder Test (SST), UCLA Activity Score (UCLA), and Constant Murley Score (CMS) were evaluated. Radiographically, the radiolucent lines (RLs), humeral head migration (HHM), and lateral glenohumeral offset (LGHO) were assessed. Survival was calculated with Kaplan−Meier curves and life-table analysis. Results: The mean CMS at follow-up was 46.2 points (range: 14−77; SD: 19.5). In terms of the SST score, the average value was 6.5 points (range: 1−10; SD: 3.5). The UCLA activity score showed a mean value of 5.9 points (range: 1−9; SD: 2.1). There were 17 revisions after a mean follow-up of 68.2 months (range: 1.8−119.6; SD: 27.9). HHM occurred in every patient, with a mean measurement of 6.4 mm (range: 0.5−13.4; SD: 3.9; p < 0.0001). The mean LGHO between the initial postoperative and follow-up images was 2.6 mm (range: 0−4.0; SD: 1.5; p < 0.0001). RLs were found in 22 patients (88%) around the glenoid and in 21 patients (84%) around the humeral head prosthesis. Conclusion: The clinical and radiographic outcomes after metal-backed glenoids were poor at 2.2 to 8.4 years of follow-up. We determined devastating survival in the majority of cases (68%), with mostly inlay wear (71%) as the main reason that led to revision surgery. The use of metalback genoids cannot be recommended based on the data of this study.

Citing Articles

High revision rate of metal-backed glenoid component and impact on the overall revision rate of stemless total shoulder arthroplasty: a cohort study from the Danish Shoulder Arthroplasty Registry.

Nyring M, Olsen B, Jensen S, Rasmussen J Acta Orthop. 2024; 95:386-391.

PMID: 39016083 PMC: 11253195. DOI: 10.2340/17453674.2024.41014.

References

Castagna A, Randelli M, Garofalo R, Maradei L, Giardella A, Borroni M . Mid-term results of a metal-backed glenoid component in total shoulder replacement. J Bone Joint Surg Br. 2010; 92(10):1410-5. DOI: 10.1302/0301-620X.92B10.23578. View

Jamari J, Ammarullah M, Md Saad A, Syahrom A, Uddin M, van der Heide E . The Effect of Bottom Profile Dimples on the Femoral Head on Wear in Metal-on-Metal Total Hip Arthroplasty. J Funct Biomater. 2021; 12(2). PMC: 8293231. DOI: 10.3390/jfb12020038. View

Boileau P, Baba M, Moineau G, Morin-Salvo N, Avidor C, Godeneche A . Response to Katz et al: The weak link in metal-backed glenoid implants is the polyethylene. J Shoulder Elbow Surg. 2016; 25(12):e396-e398. DOI: 10.1016/j.jse.2016.08.010. View

Boileau P, Avidor C, Krishnan S, Walch G, Kempf J, Mole D . Cemented polyethylene versus uncemented metal-backed glenoid components in total shoulder arthroplasty: a prospective, double-blind, randomized study. J Shoulder Elbow Surg. 2002; 11(4):351-9. DOI: 10.1067/mse.2002.125807. View

Montoya F, Magosch P, Scheiderer B, Lichtenberg S, Melean P, Habermeyer P . Midterm results of a total shoulder prosthesis fixed with a cementless glenoid component. J Shoulder Elbow Surg. 2012; 22(5):628-35. DOI: 10.1016/j.jse.2012.07.005. View

Kim S, Wise B, Zhang Y, Szabo R . Increasing incidence of shoulder arthroplasty in the United States. J Bone Joint Surg Am. 2012; 93(24):2249-54. DOI: 10.2106/JBJS.J.01994. View

Kim D, Aldeghaither M, Alabdullatif F, Shin M, Kholinne E, Kim H . Loosening and revision rates after total shoulder arthroplasty: a systematic review of cemented all-polyethylene glenoid and three modern designs of metal-backed glenoid. BMC Musculoskelet Disord. 2020; 21(1):114. PMC: 7035638. DOI: 10.1186/s12891-020-3135-6. View

Schrumpf M, Maak T, Hammoud S, Craig E . The glenoid in total shoulder arthroplasty. Curr Rev Musculoskelet Med. 2011; 4(4):191-9. PMC: 3261247. DOI: 10.1007/s12178-011-9096-5. View

Papadonikolakis A, Matsen 3rd F . Metal-Backed Glenoid Components Have a Higher Rate of Failure and Fail by Different Modes in Comparison with All-Polyethylene Components: A Systematic Review. J Bone Joint Surg Am. 2014; 96(12):1041-1047. DOI: 10.2106/JBJS.M.00674. View

10.

Boileau P, Moineau G, Morin-Salvo N, Avidor C, Godeneche A, Levigne C . Metal-backed glenoid implant with polyethylene insert is not a viable long-term therapeutic option. J Shoulder Elbow Surg. 2015; 24(10):1534-43. DOI: 10.1016/j.jse.2015.02.012. View

11.

Gregory T, Boukebous B, Gregory J, Pierrart J, Masemjean E . Short, Medium and Long Term Complications After Total Anatomical Shoulder Arthroplasty. Open Orthop J. 2017; 11:1133-1141. PMC: 5676001. DOI: 10.2174/1874325001711011133. View

12.

Lazarus M, Jensen K, Southworth C, Matsen 3rd F . The radiographic evaluation of keeled and pegged glenoid component insertion. J Bone Joint Surg Am. 2002; 84(7):1174-82. DOI: 10.2106/00004623-200207000-00013. View

13.

Magosch P, Lichtenberg S, Tauber M, Martetschlager F, Habermeyer P . Prospective midterm results of a new convertible glenoid component in anatomic shoulder arthroplasty: a cohort study. Arch Orthop Trauma Surg. 2020; 141(5):717-724. DOI: 10.1007/s00402-020-03454-y. View

14.

Gustas-French C, Petscavage-Thomas J, Bernard S . Imaging of Shoulder Arthroplasties. AJR Am J Roentgenol. 2018; 211(3):485-495. DOI: 10.2214/AJR.18.19529. View

15.

Keener J, Wei A, Kim H, Steger-May K, Yamaguchi K . Proximal humeral migration in shoulders with symptomatic and asymptomatic rotator cuff tears. J Bone Joint Surg Am. 2009; 91(6):1405-13. PMC: 2686133. DOI: 10.2106/JBJS.H.00854. View

16.

Clement N, Mathur K, Colling R, Stirrat A . The metal-backed glenoid component in rheumatoid disease: eight- to fourteen-year follow-up. J Shoulder Elbow Surg. 2010; 19(5):749-56. DOI: 10.1016/j.jse.2009.11.005. View

17.

Castagna A, Garofalo R . Journey of the glenoid in anatomic total shoulder replacement. Shoulder Elbow. 2019; 11(2):140-148. PMC: 6434953. DOI: 10.1177/1758573218790119. View

18.

Bonnevialle N, Melis B, Neyton L, Favard L, Mole D, Walch G . Aseptic glenoid loosening or failure in total shoulder arthroplasty: revision with glenoid reimplantation. J Shoulder Elbow Surg. 2012; 22(6):745-51. DOI: 10.1016/j.jse.2012.08.009. View

19.

Ammarullah M, Afif I, Maula M, Winarni T, Tauviqirrahman M, Akbar I . Tresca Stress Simulation of Metal-on-Metal Total Hip Arthroplasty during Normal Walking Activity. Materials (Basel). 2021; 14(24). PMC: 8703798. DOI: 10.3390/ma14247554. View

20.

Alolabi B, Youderian A, Napolitano L, Szerlip B, Evans P, Nowinski R . Radiographic assessment of prosthetic humeral head size after anatomic shoulder arthroplasty. J Shoulder Elbow Surg. 2014; 23(11):1740-6. DOI: 10.1016/j.jse.2014.02.013. View