Fully uncemented glenoid component in total shoulder arthroplasty.

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Radiology

Background:

• Glenoid component loosening is a primary complication in total shoulder arthroplasty.
• All-polyethylene components with cemented peg fixation have shown better biomechanical and clinical performance.
• Potential side effects associated with cementing necessitate exploring alternative fixation methods.

Purpose of the Study:

• To evaluate the necessity of cementing a specific all-polyethylene glenoid component with 3 peripheral pegs and 1 central anchor peg.
• To determine if uncemented fixation can achieve comparable clinical and radiologic outcomes.
• To assess the long-term viability of uncemented glenoid components in shoulder arthroplasty.

Main Methods:

• A cohort of 34 patients (34 shoulders) underwent total shoulder arthroplasty with an uncemented all-polyethylene glenoid component.
• Clinical outcomes were assessed using the Constant-Murley score and the SF-12 Health Survey.
• Glenoid component fixation was evaluated using computed tomography (CT) scans at a mean follow-up of 28.3 months.

Main Results:

• The Constant-Murley score significantly improved postoperatively (72 points) compared to preoperatively (40.2 points).
• SF-12 scores indicated satisfactory physical (45) and mental (50) health outcomes.
• CT scans revealed no signs of loosening in 88% (30/34) of the shoulders; loosening was observed around pegs in 4 shoulders, with no significant clinical outcome difference.

Conclusions:

• Uncemented all-polyethylene glenoid components demonstrate promising clinical and radiologic results in total shoulder arthroplasty.
• The majority of patients (88%) showed no signs of loosening on CT scans, suggesting successful uncemented fixation.
• This approach may offer a viable alternative to cemented fixation, potentially mitigating cementing-related complications.