Wednesday, December 26, 2012

Metal-backed glenoid component

An uncemented metal-backed glenoid component in total shoulder arthroplasty for osteoarthritis: factors affecting survival and outcome

As pointed out in a previous post and in this review article, the major issue with metal-backed glenoid components is not the fixation of the metal to bone, but rather the dissociation and wear of the polyethylene attached to the metal base plate.   Metal backed glenoid component are discussed in previous reports and here.

This article presents a minimum of 60 month followup of 33 shoulders with screw-fixed porous coated metal backed glenoid components inserted by an individual surgeon. The results were better than those reported previously for simlar components. The 10 year survivorship was 93%. Two were revised for polyethylene wear at 6 years and one for glenoid loosening at 11 years. Radiolucent zones were observed around six (19 %) glenoid components at last follow-up. These lucencies were apparent three years or more after superior subluxation was observed radiographically.

As the authors suggest, this is probably due to delayed rotator cuff failure, show in this figure from their article (radiograph B was obtained 8 years after the surgery). This phenomenon has been discussed in a previous post.

Younger patients and those with higher preoperative Constant scores experienced less improvement.

This is a relatively small series with encouraging results. It will be of great interest to follow the future results obtained with this prosthesis 

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