Total shoulder arthroplasty with a tissue-ingrowth glenoid component.

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering
• Medical Device Design

Background:

• Total shoulder arthroplasty (TSA) is a common treatment for severe shoulder arthritis.
• Uncemented glenoid components aim to improve long-term fixation through tissue ingrowth.
• Previous designs have faced challenges with loosening and wear.

Purpose of the Study:

• To evaluate the clinical and radiographic outcomes of a newly designed, uncemented, tissue-ingrowth glenoid component in TSA.
• To assess the complication rates and functional improvements associated with this implant.
• To identify factors influencing the success or failure of the uncemented glenoid component.

Main Methods:

• A prospective study involving 32 total shoulder arthroplasties in 29 patients.
• Utilized a novel uncemented, porous-surfaced glenoid component with a Neer humeral prosthesis.
• Follow-up included clinical assessments (pain, range of motion) and radiographic evaluation for loosening and wear, averaging 51 months.

Main Results:

• 27 of 28 shoulders without reoperation reported little to no pain.
• Average active abduction was 145°, external rotation 59°, and internal rotation 112°.
• Five complications occurred, including two glenoid dissociations, one humeral loosening, and one infection, leading to four reoperations. Three components showed probable loosening radiographically. Instability was noted in eight shoulders, with four experiencing related complications or probable loosening (p < 0.02).

Conclusions:

• The uncemented, tissue-ingrowth glenoid component shows promise for arthritic shoulders with sufficient bone stock.
• Minimizing joint instability is critical to reduce complications and the need for revision surgery.
• Further investigation into long-term outcomes and strategies to prevent instability is warranted.