Long-term clinical and radiographic outcomes of pegged vs. keeled glenoid components in total shoulder arthroplasty: A matched cohort study

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-06-18 DOI:10.1016/j.jor.2025.06.010

Akiro H. Duey , John J. Corvi , Troy Li , Alexander Park , Suhas Etigunta , Akshar V. Patel , Dennis Bienstock , William Ranson , David E. Kantrowitz , Eoghan Hurley , Dave Shukla , Bradford O. Parsons , Evan L. Flatow , Paul J. Cagle

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引用次数: 0

Abstract

Introduction

This study aimed to compare outcomes between glenoid components in shoulder replacement surgery. Our focus was on clinical and radiographic outcomes in a matched cohort study with long-term follow-up.

Methods

This study included anatomic TSA cases performed by one fellowship-trained shoulder and elbow surgeon at one institution between 2001 and 2015. The choice of glenoid implant type was made intraoperatively. All glenoids were cemented. A cardinal matching algorithm using the Matchit package in R was employed to create a 1:2 cohort of patients receiving polyethylene keeled and pegged glenoid designs. The cohort groups were matched for age, sex, pre-op ASES score, and Walch classification. Shoulder ROM and PROs were measured throughout the study. Glenoid loosening was assessed radiographically using the Lazarus scoring system.

Results

The study analyzed 36 TSAs, comprising 12 keeled glenoid components and 24 pegged components. The average follow-up was 8.9 years (range 5.0-13.4) in the keeled glenoid group and 9.2 (range 3.5-17.3) years in the pegged glenoid groups, respectively. Demographic characteristics were not significantly different. Both keeled and pegged glenoid groups showed significant improvements in all ROM and PRO measurements postoperatively. When directly compared, there were no significant differences in postoperative ROM: forward elevation (p=0.333), external rotation (p=0.462), or internal rotation (p=0.411). Similarly, no significant differences were found in postoperative PRO scores: ASES (p=0.192), SST (p=0.662), or VAS (p=0.101). A Lazarus score of 0 was the most glenoid loosening score in both cohorts, although this was not statistically significant (66.7% vs. 83.3%; p=0.479). None of the other glenoid loosening scores showed significant differences between groups. Among the 36 TSAs, one keeled glenoid (8.3%) was revised after 9.95 years due to glenoid loosening.

Discussion and conclusion:

Both glenoid configurations led to sustained postoperative improvements in ROM and PROs, and there was no meaningful variation in radiographic stability when pegged and keeled glenoids were compared.

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全肩关节置换术中固定式与龙骨式肩关节假体的长期临床和影像学结果：一项匹配队列研究

本研究的目的是比较肩关节置换术中不同肩关节部件的疗效。我们的重点是长期随访的匹配队列研究的临床和放射学结果。方法本研究包括2001年至2015年间由一名接受过奖学金培训的肩肘部外科医生在一所机构进行的解剖性TSA病例。术中选择关节盂植入物类型。所有关节盂均进行骨水泥治疗。使用R中的Matchit包的基数匹配算法创建1:2的接受聚乙烯龙骨和钉住关节盂设计的患者队列。队列组的年龄、性别、术前as评分和Walch分类相匹配。在整个研究过程中测量肩部ROM和pro。关节盂松动采用Lazarus评分系统进行影像学评估。结果本研究共分析了36例tsa，其中龙骨关节假体12例，固定式关节假体24例。龙骨盂关节组的平均随访时间为8.9年（5.0-13.4年），钉式盂关节组的平均随访时间为9.2年（3.5-17.3年）。人口统计学特征无显著差异。龙骨组和固定式关节盂组术后所有ROM和PRO测量均有显著改善。直接比较，术后ROM：前抬高（p=0.333）、外旋（p=0.462）、内旋（p=0.411）均无显著差异。同样，术后PRO评分：as （p=0.192）、SST （p=0.662）、VAS （p=0.101）均无显著差异。在两个队列中，拉撒路评分为0是最大的关节盂松动评分，尽管这没有统计学意义(66.7% vs. 83.3%；p = 0.479)。其他关节盂松动评分在两组间均无显著差异。在36例tsa中，1例（8.3%）因关节盂松动而在9.95年后进行了修正。讨论与结论：两种关节盂构型均可导致术后ROM和PROs的持续改善，并且在钉住和龙骨关节盂比较时，放射学稳定性没有显著变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.