title: Glenoid perforation does not affect the short-term outcomes of pegged all-polyethylene implants in total shoulder arthroplasty.
abstract: BACKGROUND
  The glenoid vault can be perforated during pegged glenoid preparation in total shoulder arthroplasty. The clinical implications of glenoid vault perforation, however, are unknown. The purpose of this study was to determine the effects of perforation of the glenoid during total shoulder arthroplasty on clinical and radiographic outcomes.
  
  
  METHODS
  Eighteen patients with known intraoperative glenoid perforations were prospectively identified and compared with 34 patients matched by age, gender, diagnosis, and arm dominance during the same period. Patients were evaluated with multiple outcome scores. Radiographs were evaluated for glenoid lucency immediately postoperatively and at final follow-up.
  
  
  RESULTS
  Average follow-up was 28.1 months for the perforated group and 31.2 months for the matched controls. Both groups had significant improvements in outcome scores postoperatively. American Shoulder and Elbow Surgeons scores increased from 39.8 to 91.0 (P < .001) in the perforated group and from 36.9 to 82.6 (P < .001) in the control group. Constant scores increased from 24.4 to 77.4 (P < .001) in the perforated group and from 36.9 to 75.6 (P < .001) in the control group. Ninety-four percent of the perforated group and 80% of the matched controls were satisfied or very satisfied with their result (P = .896). The presence and number of perforations were not related to the American Shoulder and Elbow Surgeons score (P = .549), Constant score (P = .154), or radiographic lucency grade (P = .584).
  
  
  CONCLUSIONS
  Glenoid perforation during pegged glenoid preparation in total shoulder arthroplasty does not seem to have an adverse effect on clinical or radiographic outcomes at an average of 2 years of follow-up.
authors.affiliation: Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA. Electronic address: cyrus.press@gmail.com.
authors.forename: Cyrus M
authors.initials: CM
authors.lastname: Press
authors.affiliation: Laboratory of Integrated Physiology, University of Houston, Houston, TX, USA.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: O'Connor
authors.affiliation: Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA.
authors.forename: Hussein A
authors.initials: HA
authors.lastname: Elkousy
authors.affiliation: Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Gartsman
authors.affiliation: Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA.
authors.forename: T Bradley
authors.initials: TB
authors.lastname: Edwards
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement / Q000009:adverse effects* / Q000295:instrumentation; D001672:Biocompatible Materials; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging; D007592:Joint Diseases / Q000601:surgery*; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D020959:Polyethylene; D011474:Prosthesis Design; D011859:Radiography; D012540:Scapula / Q000000981:diagnostic imaging / Q000293:injuries; D012785:Shoulder Joint / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D020959:Polyethylene
keywords: Glenoid perforation; outcomes; pegged implants; total shoulder arthroplasty