Five-year minimum clinical and radiographic outcomes of total shoulder arthroplasty using a hybrid glenoid component with a central porous titanium post

Clay G. Nelson, Tyler J. Brolin, Marcus C. Ford, Richard Smith, Frederick M. Azar, Thomas W. Throckmorton

Research output: Contribution to journalArticle

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Abstract

Background: To determine the effectiveness of hybrid glenoid components in reducing the frequency of glenoid component loosening, we evaluated clinical and radiographic outcomes at a minimum 5-year follow-up in 45 shoulders that underwent total shoulder arthroplasty (TSA) using a system with a central porous titanium post to augment the cemented peripheral pegs. Methods: Function and pain were evaluated with the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment score, visual analog scale, active shoulder range of motion, and strength. Postoperative radiographs were analyzed for radiolucent lines, progressive loosening, and at-risk signs. Results: The mean American Shoulder and Elbow Surgeons score improved from 40.4 to 83.7 (P <.0001) and the mean visual analog scale from 5.9 to 0.8 (P <.0001). Forward elevation improved from 113° to 151° (P <.001), internal rotation from 49° to 60° (P =.035), and mean external rotation from 36° to 50° (P =.0006). Radiographs showed glenoid component radiolucency in 29 shoulders. Radiolucencies were confined to the area under the glenoid faceplate in 6 and were only around the central post in 13. Nine TSAs (20%) demonstrated 2 or more columns of involvement but were not judged to be at-risk. One implant (2.2%) had glenoid component failure and was revised to a hemiarthroplasty. Conclusion: Anatomic TSA using a hybrid glenoid component with a central porous titanium post demonstrated a low rate of mechanical failure and a rate of radiolucent lines comparable to reports of all polyethylene implants. Further evaluations are needed to demonstrate the long-term durability of these implants and to determine the significance and fate of the radiolucent lines, particularly relative to the central post.

Original languageEnglish (US)
Pages (from-to)1462-1467
Number of pages6
JournalJournal of Shoulder and Elbow Surgery
Volume27
Issue number8
DOIs
StatePublished - Aug 1 2018

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Titanium
Arthroplasty
Elbow
Visual Analog Scale
Hemiarthroplasty
Polyethylene
Articular Range of Motion
Pain

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

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Five-year minimum clinical and radiographic outcomes of total shoulder arthroplasty using a hybrid glenoid component with a central porous titanium post. / Nelson, Clay G.; Brolin, Tyler J.; Ford, Marcus C.; Smith, Richard; Azar, Frederick M.; Throckmorton, Thomas W.

In: Journal of Shoulder and Elbow Surgery, Vol. 27, No. 8, 01.08.2018, p. 1462-1467.

Research output: Contribution to journalArticle

Nelson, Clay G. ; Brolin, Tyler J. ; Ford, Marcus C. ; Smith, Richard ; Azar, Frederick M. ; Throckmorton, Thomas W. / Five-year minimum clinical and radiographic outcomes of total shoulder arthroplasty using a hybrid glenoid component with a central porous titanium post. In: Journal of Shoulder and Elbow Surgery. 2018 ; Vol. 27, No. 8. pp. 1462-1467.
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abstract = "Background: To determine the effectiveness of hybrid glenoid components in reducing the frequency of glenoid component loosening, we evaluated clinical and radiographic outcomes at a minimum 5-year follow-up in 45 shoulders that underwent total shoulder arthroplasty (TSA) using a system with a central porous titanium post to augment the cemented peripheral pegs. Methods: Function and pain were evaluated with the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment score, visual analog scale, active shoulder range of motion, and strength. Postoperative radiographs were analyzed for radiolucent lines, progressive loosening, and at-risk signs. Results: The mean American Shoulder and Elbow Surgeons score improved from 40.4 to 83.7 (P <.0001) and the mean visual analog scale from 5.9 to 0.8 (P <.0001). Forward elevation improved from 113° to 151° (P <.001), internal rotation from 49° to 60° (P =.035), and mean external rotation from 36° to 50° (P =.0006). Radiographs showed glenoid component radiolucency in 29 shoulders. Radiolucencies were confined to the area under the glenoid faceplate in 6 and were only around the central post in 13. Nine TSAs (20{\%}) demonstrated 2 or more columns of involvement but were not judged to be at-risk. One implant (2.2{\%}) had glenoid component failure and was revised to a hemiarthroplasty. Conclusion: Anatomic TSA using a hybrid glenoid component with a central porous titanium post demonstrated a low rate of mechanical failure and a rate of radiolucent lines comparable to reports of all polyethylene implants. Further evaluations are needed to demonstrate the long-term durability of these implants and to determine the significance and fate of the radiolucent lines, particularly relative to the central post.",
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AU - Nelson, Clay G.

AU - Brolin, Tyler J.

AU - Ford, Marcus C.

AU - Smith, Richard

AU - Azar, Frederick M.

AU - Throckmorton, Thomas W.

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AB - Background: To determine the effectiveness of hybrid glenoid components in reducing the frequency of glenoid component loosening, we evaluated clinical and radiographic outcomes at a minimum 5-year follow-up in 45 shoulders that underwent total shoulder arthroplasty (TSA) using a system with a central porous titanium post to augment the cemented peripheral pegs. Methods: Function and pain were evaluated with the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment score, visual analog scale, active shoulder range of motion, and strength. Postoperative radiographs were analyzed for radiolucent lines, progressive loosening, and at-risk signs. Results: The mean American Shoulder and Elbow Surgeons score improved from 40.4 to 83.7 (P <.0001) and the mean visual analog scale from 5.9 to 0.8 (P <.0001). Forward elevation improved from 113° to 151° (P <.001), internal rotation from 49° to 60° (P =.035), and mean external rotation from 36° to 50° (P =.0006). Radiographs showed glenoid component radiolucency in 29 shoulders. Radiolucencies were confined to the area under the glenoid faceplate in 6 and were only around the central post in 13. Nine TSAs (20%) demonstrated 2 or more columns of involvement but were not judged to be at-risk. One implant (2.2%) had glenoid component failure and was revised to a hemiarthroplasty. Conclusion: Anatomic TSA using a hybrid glenoid component with a central porous titanium post demonstrated a low rate of mechanical failure and a rate of radiolucent lines comparable to reports of all polyethylene implants. Further evaluations are needed to demonstrate the long-term durability of these implants and to determine the significance and fate of the radiolucent lines, particularly relative to the central post.

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