Cementless versus cemented glenoid components in conventional total shoulder joint arthroplasty: analysis from the Australian Orthopaedic Association National Joint Replacement Registry
Version 2 2024-06-03, 20:40Version 2 2024-06-03, 20:40
Version 1 2018-05-11, 11:37Version 1 2018-05-11, 11:37
journal contribution
posted on 2018-10-01, 00:00authored byRichard PageRichard Page, V Pai, Kevin Eng, G Bain, S Graves, M Lorimer
Background: Glenoidlooseningisacommonmodeoffailureaftertotalshoulderarthroplasty(TSA).Newer cementless glenoid components have been introduced to promote biological fixation with the aim to de- crease glenoid loosening. Limited data are available comparing revision rates between cemented and cementless glenoid fixation in TSA. The study aim was to compare the revision rates of cemented and cementless design glenoid components used in conventional TSA performed for the diagnosis of osteoarthritis. The secondary aim was to compare various subclasses of glenoid components.
Methods: Data were obtained between April 16, 2004, and December 31, 2016, from the Australian Or- thopaedic Association National Joint Replacement Registry. Within the study period, 10,805 primary conventional TSAs were identified. The analysis was undertaken for the diagnosis of osteoarthritis, which represented 95.8% of all conventional TSA procedures.
Results: At5years,inpatientswithprimaryTSAprocedures,thosewithcementedglenoidshadalower revision rate than those with cementless glenoids: 3.7% versus 17.9% (hazard ratio for entire period, 4.77). The most common revision diagnosis for primary conventional TSA with cementless glenoid fixation was rotator cuff insufficiency (4.4% for cementless vs 0.4% for cemented), instability and/or dislocation (3.8% for cementless vs 0.8% for cemented), and loosening and/or lysis (1.1% for cementless vs 1.1% for cemented).
Conclusions: Cementless glenoid components in conventional TSA had a significantly higher revision rate than cemented glenoid components. The loosening rates between cemented and cementless glenoid components were similar. Glenoid design and fixation are important considerations when selecting a pros- thesis for TSA.
Level of evidence: Level III; Retrospective Cohort Design; Treatment Study