Outcomes of Trabecular Metal-backed glenoid components in anatomic total shoulder arthroplasty

J Shoulder Elbow Surg. 2018 Mar;27(3):493-498. doi: 10.1016/j.jse.2017.09.036.

Abstract

Background: As glenoid failure is one of the primary causes of failure of anatomic total shoulder arthroplasty (TSA), Trabecular Metal-backed glenoid components have become popular. This study reports implant survival and clinical outcomes of patients who received a Trabecular Metal-backed glenoid component during primary anatomic TSA.

Methods: Patients who underwent TSA with a Trabecular Metal-backed glenoid component by a single surgeon were identified and reviewed for clinical, radiographic, and patient-reported outcome measures with a minimum of 2 years' follow-up.

Results: Of 47 patients identified, radiographic and clinical follow-up was available on 36 patients (77%). Average age was 66.36 years (range, 50-85 years), and the average follow-up 41 months (range, 24-66 months). Three patients showed signs of osteolysis, 4 had radiographic evidence of metal debris, and 1 patient had a catastrophic failure after a fall. Of the 47 TSAs, 5 (11%) were revised to a reverse TSA for subscapularis failure and pain. Visual analog scale for pain scores improved by an average of 4.4. At final follow-up, the average Single Assessment Numeric Evaluation score was 72.4; Penn satisfaction score, 7.5; Penn score, 70.35; and American Shoulder and Elbow Surgeons score, 69.23. Outcome scores were similar in the 7 patients with osteolysis or metal debris compared to those without.

Conclusion: Trabecular Metal-backed glenoids had a 25% rate of radiographic metal debris and osteolysis at a minimum 2-year follow-up in this series with one catastrophic failure. This implant should be used with caution, and patients followed closely.

Keywords: Total shoulder arthroplasty; Trabecular Metal; glenoid; implant survival; loosening; osteolysis; outcomes.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Shoulder / methods*
  • Female
  • Humans
  • Joint Prosthesis*
  • Male
  • Metals*
  • Middle Aged
  • Prosthesis Design
  • Shoulder Joint / surgery*
  • Treatment Outcome

Substances

  • Metals