title: Observation of initial postoperative radiolucent lines using a modern pegged-glenoid design.
abstract: OBJECTIVE
  Glenoid component loosening remains a common mode of failure for total shoulder arthroplasty and has inspired improvements in implant design, instrumentation, and surgical technique. The purpose of this manuscript was to evaluate the incidence of radiolucent lines and glenoid seating on initial postoperative radiographs using a modern pegged-glenoid design, instrumentation, and surgical technique.
  
  
  METHODS
  We performed a retrospective analysis of a consecutive series of 100 pegged-glenoid total shoulder replacements. In cases of excessive glenoid version, the glenoid was asymmetrically reamed to recreate more normal version. Initial postoperative radiographs were evaluated for the presence of radiolucent lines and completeness of glenoid seating. The preoperative glenoid version measured on axial computed tomography (CT) scans was used to compare differences in version among those with complete and incompletely seated glenoids.
  
  
  RESULTS
  The rate of radiolucent lines observed on postoperative radiographs was 0%. Complete glenoid seating (Grade A) was observed in 81 patients (observer 1) and 82 patients (observer 2). Measurements of preoperative CT scans found a higher percentage of abnormal glenoid version for incompletely seated glenoids (47%) than completely seated glenoids (34%) but no significant difference (P = 0.327). The mean preoperative glenoid retroversion for incompletely seated glenoids was 12.1° and 9.1° for completely seated glenoids (P = 0.263).
  
  
  CONCLUSIONS
  Modern surgical techniques, surgical instrumentation, and peg glenoid design have facilitated the ability to eliminate radiolucent lines on initial postoperative radiographs with high rates of complete seating of glenoid components. Incomplete seating may be related to incomplete correction of glenoid version.
authors.affiliation: Department of Orthopedic Surgery, Holy Cross Orthopaedic Institute, Holy Cross Hospital, Fort Lauderdale, FL 33334, USA.
authors.forename: Nathan G
authors.initials: NG
authors.lastname: Everding
authors.affiliation: Department of Orthopedic Surgery, Holy Cross Orthopaedic Institute, Holy Cross Hospital, Fort Lauderdale, FL 33334, USA.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Levy
authors.affiliation: Department of Orthopedic Surgery, Holy Cross Orthopaedic Institute, Holy Cross Hospital, Fort Lauderdale, FL 33334, USA.
authors.forename: Nathan T
authors.initials: NT
authors.lastname: Formaini
authors.affiliation: Department of Orthopedic Surgery, Holy Cross Orthopaedic Institute, Holy Cross Hospital, Fort Lauderdale, FL 33334, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Blum
authors.affiliation: Department of Orthopedic Surgery, Holy Cross Orthopaedic Institute, Holy Cross Hospital, Fort Lauderdale, FL 33334, USA.
authors.forename: Carlos C
authors.initials: CC
authors.lastname: Gil
authors.affiliation: Department of Orthopedic Surgery, Holy Cross Orthopaedic Institute, Holy Cross Hospital, Fort Lauderdale, FL 33334, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Verde
keywords: Glenoid component; pegged-glenoid; radiolucent lines; total shoulder arthroplasty