Survival of the glenoid component in shoulder arthroplasty

Introduction

This study was conducted to determine the survival of different glenoid component designs, assess the reasons for revision surgery, and identify patient and diagnostic factors that influence this need.

Methods

Between January 1, 1984, and December 31, 2004, 1337 patients underwent 1542 total shoulder arthroplasties with 6 types of glenoid components: Neer II all-polyethylene, Neer II metal-backed, Cofield 1 metal-backed bone-ingrowth, Cofield 1 all-poly keeled, Cofield 2 all-poly keeled, and Cofield 2 all-poly pegged.

Results

Revision was required in 125 shoulders for glenoid component failure. Survival rates free of revision by glenoid implant type at 5, 10, and 15 years were, respectively, 96%, 96%, and 95% for 99 Neer II all-poly; 96%, 94%, and 89% for 316 Neer II metal-backed; 86%, 79%, and 67% for 316 Cofield 1 metal-backed; 94%, 94%, and 87% for 18 Cofield 1 all-poly; 99%, 94%, and 89% for 497 Cofield 2 all-poly keeled; and 99% at 5 years for 358 Cofield 2 all-poly pegged. Glenoid component type was significantly associated with component revision (P < .001). Male gender was associated with a higher risk of revision (P < .001). Compared with degenerative arthritis, posttraumatic arthritis (P = .02) and avascular necrosis (P = .06) were associated with increased risk of revision.

Conclusions

Survival is improved with cemented all-polyethylene glenoid components. Revision of cemented all-polyethylene components may be lessened with the use of pegged components in early follow-up. Male gender and the operative diagnoses of posttraumatic arthritis or avascular necrosis are associated with an increased risk of failure.

Level of Evidence

Level IV, Case Series, Treatment Study.

Keywords: Glenoid survival, total shoulder arthroplasty, glenoid component failure, revision surgery, all-polyethylene components