Friday, April 26, 2013

glenoid component, uncemented, in total shoulder arthroplasty - disclosure

Fully uncemented glenoid component in total shoulder arthroplasty

Before we get in to the article, a few observations about disclosure may be in order. The disclaimer section for this article is reproduce here:

The implant used in this study is identified here

And the AAOS disclosure website reveals that multiple authors receive benefits from the company making the prosthesis as shown here

While there is no reason that an author shouldn't receive royalties for his/her invention, disclosures are important and need to be accurate and complete.

This is a report of 34 shoulders having total shoulders with a glenoid component the primary fixation of which is a central peg that was designed to fix the component without cement. The FDA approval of the device has stipulated that cement be used in the peripheral pegs. The purpose of cement in these peripheral holes was to reduce the risk of rocking horse loosening from eccentric loading.

In this study, the component was inserted without cement in the peripheral holes. 12% of the components showed signs of loosening around the central anchor peg and the peripheral pegs on CT scans at two year followup, yielding a 6% per year loosening rate. This annualized rate is higher than for many of the published series of all polyethylene glenoids. This may be because the authors did very thorough evaluation of the shoulders with CT scans. We also know that glenoid component loosening often does not become evident until five or more years after shoulder arthroplasty.

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