What correlates with glenoid radiolucency at 10 years after total shoulder arthroplasty?

 Computed tomography revealed the correlation between radiolucency and alignment of all-polyethylene pegged glenoid component more than 10 years after total shoulder arthroplasty in the Japanese population

These authors sought to evaluate the long-term outcomes after anatomic total shoulder arthroplasty (TSA) and to identify factors related to radiolucency around the glenoid component using CT after at least 10 years of clinical follow up. 

They defined glenoid superior inclination as the angle between the glenoid and a line perpendicular to the floor of the supraspinatus fossa.

Eighteen shoulders in 16 patients met the inclusion criteria. Mean patient age was 61 years, mean follow up period was 137 months, and mean Yian CT score was 19%. Glenoid radiolucency values were significantly higher in patients with rheumatoid arthritis than in those with osteoarthritis.

CT score for radiolucency was significantly highest in pegs located inferiorly. 

Glenoid superior inclination was significantly lower in shoulders with possible loosening than in cases with no loosening (5 vs 16 degrees) - in other words glenoids that were more inferiorly inclined were more likely to have possible glenoid loosening. Notably, glenoid retroversion, glenohumeral decentering, and critical shoulder angles were not different for the possible loosening and no glenoid loosening groups.

Shoulders with possible glenoid loosening had inferior clinical outcomes.

Comment: While the numbers in this study are small, it is of interest to note the outcomes 10 years after surgery. The hypothesis that needs further testing is that relatively inferior inclination of the glenoid component may create a greater loosening moment for the superiorly directed forces applied by the deltoid with increased traction on the inferior pegs of the component leading to radiolucencies around them,

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Here are some videos that are of shoulder interest

Shoulder arthritis - what you need to know (see this link)

Shoulder arthritis - x-ray appearance (see this link)

The smooth and move for irreparable cuff tears (see this link)

The total shoulder arthroplasty (see this link).

The ream and run technique is shown in this link.

The cuff tear arthropathy arthroplasty (see this link).

The reverse total shoulder arthroplasty (see this link).

Shoulder rehabilitation exercises (see this link).

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Note that author has no financial relationships with any orthopaedic companies.