title: Five- to ten-year follow-up with a partially cemented all-polyethylene bone-ingrowth glenoid component.
abstract: BACKGROUND
  Although total shoulder arthroplasty has demonstrated better clinical outcomes than hemiarthroplasty, glenoid component loosening is a common complication. Recently, a novel partially cemented all-polyethylene fluted central peg bone-ingrowth component was introduced.
  
  
  METHODS
  Forty-two consecutive total shoulder arthroplasties from 2003 to 2007 performed by a single surgeon were evaluated radiographically and clinically with American Shoulder and Elbow Surgeons (ASES) scores and range of motion.
  
  
  RESULTS
  The average follow-up was 80 months (63-114); the average forward elevation improved from 107° to 137°, and external rotation improved from 30° to 37° at the latest follow-up. The average ASES score improved from 50 to 84. There was a strong correlation with the mean peripheral peg lucent line score (Lazarus score), which was 0.81, with the mean anchor peg lucent line score, which was 0.50 (P < .001). An analysis of polyethylene before and after cross-linking revealed a strong correlation between components with cross-linking and the Lazarus scores and the central fluted peg scores. Overall, there was 97% survivorship at 80 months. On radiographs, 81% of the central fluted pegs had complete incorporation with no lucent lines. These lucent lines correlated with lower ASES scores, suggesting that loosening of the glenoid decreases functional outcome.
  
  
  CONCLUSIONS
  Care should be taken in preparing the central fluted peg as perforation of the vault can lead to central flute peg lucent line formation, whereas perforation of the peripheral pegs does not seem to negatively affect the outcome.
authors.affiliation: Shoulder and Elbow Service, East Ohio Orthopaedics, Dover, OH, USA. Electronic address: noyes48@aol.com.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Noyes
authors.affiliation: Department of Mechanical, Aerospace, and Biomedical Engineering, University of Tennessee, Knoxville, TN, USA.
authors.forename: Bradley
authors.initials: B
authors.lastname: Meccia
authors.affiliation: Shoulder and Elbow Service, Knoxville Orthopaedic Clinic, Knoxville, TN, USA.
authors.forename: Edwin E
authors.initials: EE
authors.lastname: Spencer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement; D001672:Biocompatible Materials; D002484:Cementation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D020959:Polyethylene; D011475:Prosthesis Failure; D012540:Scapula / Q000601:surgery; D012785:Shoulder Joint / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D020959:Polyethylene
keywords: Shoulder; bone ingrowth; cement; glenoid; peg; polyethylene; total shoulder arthroplasty