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05.05.2022 | Review Article

The glenoid: a weak link in total shoulder arthroplasty

Metal backs as possible solutions and future perspectives

verfasst von: Alessandro Castagna, Giacomo Delle Rose, Mario Borroni, Stefano Gumina, Raffaele Garofalo, Riccardo Ranieri, MD

Erschienen in: Obere Extremität | Ausgabe 2/2022

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Abstract

Background

Glenoid component loosening and failure remains the most common complication of total shoulder arthroplasty (TSA). All-polyethylene (PE) glenoids have shown considerable rates for progressive radiolucent lines (RLL) and glenoid loosening. Metal-backed glenoids (MBGs) where introduced in attempt to improved glenoid fixation, but controversial results are reported in the literature. The aim of this article was to summarize the state of art of MBGs and modern glenoid solutions in TSA.

Materials and methods

A selective PubMed literature search was performed in order to analyze the rationale behind MBG, reporting current biomechanical and clinical evidences and exploring potential future directions.

Results

Several different MBGs were introduced since the first uncemented MBG presented by Cofield. Most of them were abandoned due to high revision rate and unsatisfactory survival rate. Main implant-related complications involved component or screw breakage, component dissociation, PE and metal wear. Most of these problems were solved by the design evolution. PE wear remains the main problem, but new convertible platforms allow easy revision to reverse prosthesis maintaining the metal baseplate with good clinical results.

Conclusion

Clinical results regarding MBGs are controversial and confused, mainly due to the fact that several designs were introduced in the past with crucial differences among them. Even if modern designs presented better results and solved some common complications encountered with old MBGs, the field of the glenoid in anatomic replacement remains the main space for innovation in shoulder arthroplasty.

Anglin C, Wyss UP, Nyffeler RW, Gerber C (2001) Loosening performance of cemented glenoid prosthesis design pairs. Clin Biomech (Bristol Avon) 16:144–150. https://doi.org/10.1016/s0268-0033(00)00078-4CrossRef

Anglin C, Wyss UP, Pichora DR (2000) Mechanical testing of shoulder prostheses and recommendations for glenoid design. J Shoulder Elbow Surg 9:323–331. https://doi.org/10.1067/mse.2000.105451CrossRefPubMed

Bicknell RT, Liew ASL, Danter MR et al (2007) The influence of implant articular thickness and glenohumeral conformity on stability of an all-metal glenoid component. J Shoulder Elbow Surg 16:631–639. https://doi.org/10.1016/j.jse.2006.10.014CrossRefPubMed

Bohsali KI, Bois AJ, Wirth MA (2017) Complications of shoulder arthroplasty. J Bone Joint Surg Am 99:256–269. https://doi.org/10.2106/JBJS.16.00935CrossRefPubMed

Boileau P, Avidor C, Krishnan SG et al (2002) Cemented polyethylene versus uncemented metal-backed glenoid components in total shoulder arthroplasty: a prospective, double-blind, randomized study. J Shoulder Elbow Surg 11:351–359. https://doi.org/10.1067/mse.2002.125807CrossRefPubMed

Boileau P, Moineau G, Morin-Salvo N et al (2015) Metal-backed glenoid implant with polyethylene insert is not a viable long-term therapeutic option. J Shoulder Elbow Surg 24:1534–1543. https://doi.org/10.1016/j.jse.2015.02.012CrossRefPubMed

Budge MD, Nolan EM, Heisey MH et al (2013) Results of total shoulder arthroplasty with a monoblock porous tantalum glenoid component: a prospective minimum 2‑year follow-up study. J Shoulder Elbow Surg 22:535–541. https://doi.org/10.1016/j.jse.2012.06.001CrossRefPubMed

Castagna A, Delcogliano M, de Caro F et al (2013) Conversion of shoulder arthroplasty to reverse implants: clinical and radiological results using a modular system. Int Orthop 37:1297–1305. https://doi.org/10.1007/s00264-013-1907-4CrossRefPubMedPubMedCentral

Castagna A, Garofalo R (2019) Journey of the glenoid in anatomic total shoulder replacement. Shoulder Elbow 11:140–148. https://doi.org/10.1177/1758573218790119CrossRefPubMed

10.

Castagna A, Randelli M, Garofalo R et al (2010) Mid-term results of a metal-backed glenoid component in total shoulder replacement. J Bone Joint Surg Br 92:1410–1415. https://doi.org/10.1302/0301-620X.92B10.23578CrossRefPubMed

11.

Clement ND, Duckworth AD, Colling RC, Stirrat AN (2013) An uncemented metal-backed glenoid component in total shoulder arthroplasty for osteoarthritis: factors affecting survival and outcome. J Orthop Sci 18:22–28. https://doi.org/10.1007/s00776-012-0308-7CrossRefPubMed

12.

Cofield RH (1994) Uncemented total shoulder arthroplasty. A review. Clin Orthop Relat Res 307:86–93

13.

Cofield RH, Daly PJ (1992) Total shoulder arthroplasty with a tissue-ingrowth glenoid component. J Shoulder Elbow Surg 1:77–85. https://doi.org/10.1016/S1058-2746(09)80124-9CrossRefPubMed

14.

Collin P, Tay AKL, Melis B et al (2011) A ten-year radiologic comparison of two-all polyethylene glenoid component designs: a prospective trial. J Shoulder Elbow Surg 20:1217–1223. https://doi.org/10.1016/j.jse.2011.06.012CrossRefPubMed

15.

De Wilde L, Dayerizadeh N, De Neve F et al (2013) Fully uncemented glenoid component in total shoulder arthroplasty. J Shoulder Elbow Surg 22:e1–e7. https://doi.org/10.1016/j.jse.2013.01.036CrossRefPubMed

16.

Endrizzi DP, Mackenzie JA, Henry PDG (2016) Early debris formation with a porous tantalum glenoid component: radiographic analysis with 2‑year minimum follow-up. J Bone Joint Surg Am 98:1023–1029. https://doi.org/10.2106/JBJS.15.00410CrossRefPubMed

17.

Fox TJ, Cil A, Sperling JW et al (2009) Survival of the glenoid component in shoulder arthroplasty. J Shoulder Elbow Surg 18:859–863. https://doi.org/10.1016/j.jse.2008.11.020CrossRefPubMed

18.

Fucentese SF, Costouros JG, Kühnel S‑P, Gerber C (2010) Total shoulder arthroplasty with an uncemented soft-metal-backed glenoid component. J Shoulder Elbow Surg 19:624–631. https://doi.org/10.1016/j.jse.2009.12.021CrossRefPubMed

19.

Fukuda K, Chen CM, Cofield RH, Chao EY (1988) Biomechanical analysis of stability and fixation strength of total shoulder prostheses. Orthopedics 11:141–149CrossRef

20.

Gonzalez J‑F, Alami GB, Baque F et al (2011) Complications of unconstrained shoulder prostheses. J Shoulder Elbow Surg 20:666–682. https://doi.org/10.1016/j.jse.2010.11.017CrossRefPubMed

21.

Jacxsens M, Dayerizadeh N, Vandenbosch D et al (2020) Clinical and radiographic outcomes of an all-polyethylene fluted central peg glenoid component, implanted utilizing an off-label, uncemented technique, at a minimum 5‑year follow-up. J Shoulder Elbow Surg 29:2292–2298. https://doi.org/10.1016/j.jse.2020.02.027CrossRefPubMed

22.

Katz D, Kany J, Valenti P et al (2013) New design of a cementless glenoid component in unconstrained shoulder arthroplasty: a prospective medium-term analysis of 143 cases. Eur J Orthop Surg Traumatol 23:27–34. https://doi.org/10.1007/s00590-012-1109-6CrossRefPubMed

23.

Kim DM, Alabdullatif F, Aldeghaither M et al (2020) Do modern designs of metal-backed glenoid components show improved clinical results in total shoulder arthroplasty? A systematic review of the literature. Orthop J Sports Med 8:2325967120950307. https://doi.org/10.1177/2325967120950307CrossRefPubMedPubMedCentral

24.

Kocsis G, Payne CJ, Wallace A, McNally D (2018) Wear analysis of explanted conventional metal back polyethylene glenoid liners. Med Eng Phys 59:1–7. https://doi.org/10.1016/j.medengphy.2018.03.010CrossRefPubMed

25.

Magosch P, Habermeyer P, Vetter P (2021) Radiologic midterm results of cemented and uncemented glenoid components in primary osteoarthritis of the shoulder: a matched pair analysis. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-021-04021-9CrossRefPubMed

26.

Martin SD, Zurakowski D, Thornhill TS (2005) Uncemented glenoid component in total shoulder arthroplasty. Survivorship and outcomes. J Bone Joint Surg Am 87:1284–1292. https://doi.org/10.2106/JBJS.C.00947CrossRefPubMed

27.

Merolla G, Chin P, Sasyniuk TM et al (2016) Total shoulder arthroplasty with a second-generation tantalum trabecular metal-backed glenoid component: Clinical and radiographic outcomes at a mean follow-up of 38 months. Bone Joint J 98:75–80. https://doi.org/10.1302/0301-620X.98B1.36620CrossRefPubMed

28.

Montoya F, Magosch P, Scheiderer B et al (2013) Midterm results of a total shoulder prosthesis fixed with a cementless glenoid component. J Shoulder Elbow Surg 22:628–635. https://doi.org/10.1016/j.jse.2012.07.005CrossRefPubMed

29.

Neer CS (1974) Replacement arthroplasty for glenohumeral osteoarthritis. J Bone Joint Surg Am 56:1–13CrossRef

30.

Nelson CG, Brolin TJ, Ford MC et al (2018) Five-year minimum clinical and radiographic outcomes of total shoulder arthroplasty using a hybrid glenoid component with a central porous titanium post. J Shoulder Elbow Surg 27:1462–1467. https://doi.org/10.1016/j.jse.2018.01.012CrossRefPubMed

31.

Nho SJ, Nam D, Ala OL et al (2009) Observations on retrieved glenoid components from total shoulder arthroplasty. J Shoulder Elbow Surg 18:371–378. https://doi.org/10.1016/j.jse.2008.12.006CrossRefPubMed

32.

Nuttall D, Haines JF, Trail II (2007) A study of the micromovement of pegged and keeled glenoid components compared using radiostereometric analysis. J Shoulder Elbow Surg 16:S65–S70. https://doi.org/10.1016/j.jse.2006.01.015CrossRefPubMed

33.

Orr TE, Carter DR, Schurman DJ (1988) Stress analyses of glenoid component designs. Clin Orthop Relat Res 232:217–224CrossRef

34.

Papadonikolakis A, Matsen FA (2014) Metal-backed glenoid components have a higher rate of failure and fail by different modes in comparison with all-polyethylene components: a systematic review. J Bone Joint Surg Am 96:1041–1047. https://doi.org/10.2106/JBJS.M.00674CrossRefPubMed

35.

Papadonikolakis A, Neradilek MB, Matsen FA (2013) Failure of the glenoid component in anatomic total shoulder arthroplasty: a systematic review of the English-language literature between 2006 and 2012. J Bone Joint Surg Am 95:2205–2212. https://doi.org/10.2106/JBJS.L.00552CrossRefPubMed

36.

Rosenberg N, Neumann L, Modi A et al (2007) Improvements in survival of the uncemented Nottingham Total Shoulder prosthesis: a prospective comparative study. BMC Musculoskelet Disord 8:76. https://doi.org/10.1186/1471-2474-8-76CrossRefPubMedPubMedCentral

37.

Stone KD, Grabowski JJ, Cofield RH et al (1999) Stress analyses of glenoid components in total shoulder arthroplasty. J Shoulder Elbow Surg 8:151–158. https://doi.org/10.1016/s1058-2746(99)90009-5CrossRefPubMed

38.

Stone MA, Noorzad AS, Namdari S, Abboud J (2021) Prosthetic bearing surfaces in anatomic and reverse total shoulder arthroplasty. J Am Acad Orthop Surg 29:414–422. https://doi.org/10.5435/JAAOS-D-20-00166CrossRefPubMed

39.

Swieszkowski W, Bednarz P, Prendergast PJ (2003) Contact stresses in the glenoid component in total shoulder arthroplasty. Proc Inst Mech Eng H 217:49–57. https://doi.org/10.1243/095441103762597737CrossRefPubMed

40.

Taunton MJ, McIntosh AL, Sperling JW, Cofield RH (2008) Total shoulder arthroplasty with a metal-backed, bone-ingrowth glenoid component. Medium to long-term results. J Bone Joint Surg Am 90:2180–2188. https://doi.org/10.2106/JBJS.G.00966CrossRefPubMed

41.

Thomas R, Richardson M, Patel M et al (2018) Rotator cuff contact pressures at the tendon-implant interface after anatomic total shoulder arthroplasty using a metal-backed glenoid component. J Shoulder Elbow Surg 27:2085–2092. https://doi.org/10.1016/j.jse.2018.04.017CrossRefPubMed

42.

Walch G, Edwards TB, Boulahia A et al (2002) The influence of glenohumeral prosthetic mismatch on glenoid radiolucent lines: results of a multicenter study. J Bone Joint Surg Am 84:2186–2191. https://doi.org/10.2106/00004623-200212000-00010CrossRefPubMed

43.

Watson ST, Gudger GK, Long CD et al (2018) Outcomes of Trabecular Metal-backed glenoid components in anatomic total shoulder arthroplasty. J Shoulder Elbow Surg 27:493–498. https://doi.org/10.1016/j.jse.2017.09.036CrossRefPubMed

44.

Welsher A, Gohal C, Madden K et al (2019) A comparison of pegged vs. keeled glenoid components regarding functional and radiographic outcomes in anatomic total shoulder arthroplasty: a systematic review and meta-analysis. JSES Open Access 3:136–144.e1. https://doi.org/10.1016/j.jses.2019.04.002CrossRefPubMedPubMedCentral

45.

Young AA, Walch G, Pape G et al (2012) Secondary rotator cuff dysfunction following total shoulder arthroplasty for primary glenohumeral osteoarthritis: results of a multicenter study with more than five years of follow-up. J Bone Joint Surg Am 94:685–693. https://doi.org/10.2106/JBJS.J.00727CrossRefPubMed

46.

Cementless surface replacement arthroplasty (Copeland CSRA) for osteoarthritis of the shoulder—Search Results—PubMed. https://pubmed.ncbi.nlm.nih.gov/?term=Cementless+surface+replacement+arthroplasty+%28Copeland+CSRA%29+for+osteoarthritis+of+the+shoulder&sort=date. Accessed 1 Nov 2021

Titel: The glenoid: a weak link in total shoulder arthroplasty
Metal backs as possible solutions and future perspectives
verfasst von: Alessandro Castagna
Giacomo Delle Rose
Mario Borroni
Stefano Gumina
Raffaele Garofalo
Riccardo Ranieri, MD
Publikationsdatum: 05.05.2022
Verlag: Springer Medizin
Erschienen in: Obere Extremität / Ausgabe 2/2022
Print ISSN: 1862-6599
Elektronische ISSN: 1862-6602
DOI: https://doi.org/10.1007/s11678-022-00690-z

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Background

Materials and methods

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