title: Clinical and Radiographic Results of an All-Polyethylene Pegged Bone-Ingrowth Glenoid Component.
abstract: BACKGROUND
  Loosening of the glenoid component continues to be the main cause of medium and long-term failure of shoulder replacements. The purpose of this study was to evaluate the early clinical and radiographic results following use of an all-polyethylene pegged glenoid component designed for hybrid (biological and cement) fixation.
  
  
  METHODS
  Eighty-three shoulders in 77 patients (mean age, 68.6 years) underwent total shoulder arthroplasty with a pegged hybrid-fixation component (bone-ingrowth glenoid and cemented peg). Outcomes were determined with the American Shoulder and Elbow Surgeons (ASES) score and the Oxford shoulder score. A detailed analysis of radiographs and fine-slice computed tomography (CT) images was performed to determine the extent of bone ingrowth between the flanges and the extent of radiolucent lines at the prosthesis-bone interface.
  
  
  RESULTS
  The mean duration of follow-up was 46.7 months (range, 24 to 99 months). At the time of final follow-up, the median ASES score was 97 points (range, 43 to 100 points) and the median Oxford score was 48 points (range, 24 to 48 points). The median active forward elevation was 130° (range, 65° to 170°), median external rotation was 45° (range, 5° to 80°), and median internal rotation was to T11 (range, buttock to T4). Seventy-eight shoulders demonstrated a perfect Lazarus score for radiolucency (0, indicating no radiolucency). Sixty-eight shoulders demonstrated complete osseointegration, with bone ingrowth between all of the flanges seen on coronal CT; 5 demonstrated partial osseointegration; and 10 demonstrated osteolysis around the central peg. Most radiolucent lines were in the inferior Yian zones. There were no correlations between the Yian CT scores and either the ASES or Oxford score (rho = 0.13 and 0.07, respectively).
  
  
  CONCLUSIONS
  Total shoulder arthroplasty with an all-polyethylene pegged glenoid component, utilizing hybrid fixation, demonstrated excellent clinical and radiographic results at the time of early follow-up. Radiolucent lines were seen most commonly around the inferior pegs of the prosthesis, and this may represent an incipient mode of failure.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom malinwijeratna@doctors.net.uk.
authors.forename: Malin
authors.initials: M
authors.lastname: Wijeratna
authors.affiliation: Austin Hospital, Heidelberg, Victoria, Australia.
authors.forename: David McD
authors.initials: DM
authors.lastname: Taylor
authors.affiliation: The Avenue Hospital, Windsor, Victoria, Australia.
authors.forename: Steven
authors.initials: S
authors.lastname: Lee
authors.affiliation: Melbourne Orthopaedic Group, Windsor, Victoria, Australia Department of Surgery, Monash University, Melbourne, Victoria, Australia.
authors.forename: Gregory
authors.initials: G
authors.lastname: Hoy
authors.affiliation: Melbourne Orthopaedic Group, Windsor, Victoria, Australia Department of Surgery, Monash University, Melbourne, Victoria, Australia.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Evans
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000072228:Arthroplasty, Replacement, Shoulder / Q000379:methods*; D001843:Bone Cements; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D020959:Polyethylene; D011474:Prosthesis Design; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D000072227:Shoulder Prosthesis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements; D020959:Polyethylene