Sunday, June 26, 2011

Shoulder arthritis at the 2011 ASES meeting - glenoid loosening

Three papers presented at the most recent open meeting of the American Shoulder and Elbow Surgeons (February 19, 2011, San Diego) relate to the issue of glenoid component failure, even with modern components and techniques in expert surgical hands.

Out of 518 total shoulders from 10 European surgical centers using a third generation anatomic prosthesis, radiographic loosening was found in 32% at an average of 8.6 years after surgery (Walch G, Young AA, Boileau P, et al.: Patterns of loosening of a cemented polyethylene keeled glenoid component in primary osteoarthritis - Results of a multicenter study).

The Mayo Clinic group reported essentially identical results with a different prosthesis:  in 157 total shoulder arthroplasties using a cemented Cofield II keeled all-polyethylene glenoid component, 32% of the glenoids showed radiographic failure at 10 years ( Fox TJ, Foruria A, Klika B, et al.: Radiographic survival in total shoulder arthroplasty).

A multicenter French report using a modern uncemented metal-back glenoid component found that at 12-year follow-up, approximately half of the glenoid prostheses had been revised for wear or loosening (Moineau G, Morin-Salvo N, Walch G, et al.: Long-term results of anatomical total shoulder arthroplasty with metal-backed glenoid components implanted for primary glenohumeral joint osteoarthritis).

These studies indicate the need for long term followup to determine the survivorship of the glenoid component in total shoulder arthroplasty.


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