title: New design of a cementless glenoid component in unconstrained shoulder arthroplasty: a prospective medium-term analysis of 143 cases.
abstract: The uncemented glenoid implants in total anatomical shoulder arthroplasty are likely to be accused of problems like dissociations, secondary rotator cuff tear, and wear of polyethylene (PE). This work is a clinical and radiological prospective review of 143 cases of anatomical total shoulder arthroplasty using a new metal back uncemented glenoid implant (MB) in order to see if this new implant induces those complications. A total of 143 cases were operated between 2003 and 2011. In a first part, the whole series of 143 cases was radiologically studied in order to quantify the lateralisation induced by the MB implant. In a second study, 37 cases had a mean follow-up of 38 months (24-75, mean 32) and served for the clinical and radiological final study. Pre- and postoperative clinical evaluation was done using the Constant-Murley score and the simple shoulder test from Matsen. The final X-rays served to detect an eventual secondary narrowing of the joint space and to analyse the frequency of radio lucent lines (RLL) and loosenings. Despite a small radiological lateralisation in comparison with the normal contralateral side (0.36 cm, p = 0.02), the clinical results after 2 years were similar to the published cemented glenoid implants series but without any RLL, glenoid loosening or joint narrowing. Some dissociations occured in the beginning and definitely eliminated by a design modification of the PE tray. The discussion tried to show that, despite a still short follow-up, this series is encouraging to continue to use this new MB implant. Different applications of the concept of universality and conversion are discussed, this tray been also the support of a glenosphere in reverse arthroplasty.
authors.affiliation: Clinique du Ter, 56270 Ploemeur, France. denis.katz@wanadoo.fr
authors.forename: D
authors.initials: D
authors.lastname: Katz
authors.forename: J
authors.initials: J
authors.lastname: Kany
authors.forename: P
authors.initials: P
authors.lastname: Valenti
authors.forename: P
authors.initials: P
authors.lastname: Sauzières
authors.forename: P
authors.initials: P
authors.lastname: Gleyze
authors.forename: K
authors.initials: K
authors.lastname: El Kholti
mesh_terms: D000328:Adult; D000368:Aged; D019643:Arthroplasty, Replacement / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D061165:Glenoid Cavity / Q000293:injuries / Q000601:surgery*; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design / Q000009:adverse effects; D000070636:Rotator Cuff Injuries; D012783:Shoulder Dislocation / Q000209:etiology; D012785:Shoulder Joint / Q000601:surgery*; D017695:Soft Tissue Injuries / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult