title: A multicentre study of the long-term results of using a flat-back polyethylene glenoid component in shoulder replacement for primary osteoarthritis.
abstract: We report the long-term clinical and radiological outcomes of the Aequalis total shoulder replacement with a cemented all-polyethylene flat-back keeled glenoid component implanted for primary osteoarthritis between 1991 and 2003 in nine European centres. A total of 226 shoulders in 210 patients were retrospectively reviewed at a mean of 122.7 months (61 to 219) or at revision. Clinical outcome was assessed using the Constant score, patient satisfaction score and range of movement. Kaplan-Meier survivorship analysis was performed with glenoid revision for loosening and radiological glenoid loosening (SD) as endpoints. The Constant score was found to improve from a mean of 26.8 (SD 10.3) pre-operatively to 57.6 (SD 20.0) post-operatively (p < 0.001). Active forward flexion improved from a mean of 85.3° (SD 27.4) pre-operatively to 125° (SD 37.3) postoperatively (p < 0.001). External rotation improved from a mean of 7° (SD 6.5) pre-operatively to 30.3° (SD 21.8°) post-operatively (p < 0.001). Survivorship with revision of the glenoid component as the endpoint was 99.1% at five years, 94.5% at ten years and 79.4% at 15 years. Survivorship with radiological loosening as the endpoint was 99.1% at five years, 80.3% at ten years and 33.6% at 15 years. Younger patient age and the curettage technique for glenoid preparation correlated with loosening. The rate of glenoid revision and radiological loosening increased with duration of follow-up, but not until a follow-up of five years. Therefore, we recommend that future studies reporting radiological outcomes of new glenoid designs should report follow-up of at least five to ten years.
authors.affiliation: Sydney Shoulder Specialists, Suite 201, Level 2, 156 Pacific Highway, St Leonards, Sydney 2065, Australia. drallanyoung@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Young
authors.forename: G
authors.initials: G
authors.lastname: Walch
authors.forename: P
authors.initials: P
authors.lastname: Boileau
authors.forename: L
authors.initials: L
authors.lastname: Favard
authors.forename: F
authors.initials: F
authors.lastname: Gohlke
authors.forename: M
authors.initials: M
authors.lastname: Loew
authors.forename: D
authors.initials: D
authors.lastname: Molé
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000009:adverse effects / Q000379:methods*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D017060:Patient Satisfaction; D011095:Polyethylenes; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D016059:Range of Motion, Articular; D012086:Reoperation; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D011095:Polyethylenes