These authors used the New Zealand Joint Registry (NZJR) data from from January 2000 to December 2017 to compare all-cause revision rates and functional scores for total shoulder arthroplasty (TSA) and investigated the trends of glenoid fixation used in New Zealand.
A total of 2613 TSAs were performed for OA during the study period, representing 85.0% of all TSAs in New Zealand. 69.6% of glenoids were cemented and 30.4% uncemented. The most common uncemented MB glenoids were the SMR 86.6% (LimaCorporate) and the Bigliani-Flatow.
The most common cemented glenoid components were Global (DePuy) 49.8% and Aequalis.
The revision rate for TSA with uncemented glenoids was significantly higher at 2.03 compared with cemented at 0.41 per 100 component-years.
The hazard ratio was 5.0 for revision of uncemented glenoids.
The most common mode of failure was glenoid loosening in cemented glenoids (44.4%), and component failure in uncemented (34.8%).
Revision for rotator cuff, deep infection, and instability were comparable between
groups.
When excluding SMR L2, uncemented MB glenoid all-cause revision rates remained significantly higher than cemented (1.42 vs. 0.41 per 100 component-years, P < .001). SMR L1 uncemented MB glenoids had a higher revision rate than the non-SMR uncemented glenoids (1.61 vs. 0.18 per 100 component-years.
Uncemented glenoid use peaked in New Zealand in 2011 at 46.7% of TSAs but declined to 20.1% in 2017.
Comment: These data reinforce prior studies showing the superior survivorship for cemented cross linked all-polyethylene glenoids (see data below from the Australian Orthopaedic Association).
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