Comparing outcomes of central ingrowth peg vs. noningrowth pegged glenoid components during revision to reverse total shoulder arthroplasty

Samuel K Simister; Eleanor H Sato; Kory Fleming; Peter N Chalmers; Robert Z Tashjian

doi:10.1016/j.jseint.2023.03.009

Comparing outcomes of central ingrowth peg vs. noningrowth pegged glenoid components during revision to reverse total shoulder arthroplasty

JSES Int. 2023 Apr 12;7(4):623-627. doi: 10.1016/j.jseint.2023.03.009. eCollection 2023 Jul.

Authors

Samuel K Simister¹, Eleanor H Sato¹, Kory Fleming¹, Peter N Chalmers¹, Robert Z Tashjian¹

Affiliation

¹ Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA.

Abstract

Background: One innovation to reduce glenoid loosening in total shoulder arthroplasty (TSA) is a large, central ingrowth peg. However, when bone ingrowth fails to occur, there is often increased bone loss surrounding the central peg which may increase complexity of subsequent revisions. Our goal was to compare outcomes between central ingrowth pegs and noningrowth pegged glenoid components during revision to reverse total shoulder arthroplasty.

Methods: In a comparative retrospective case series, all patients who underwent TSA-to-reverse TSA revision between 2014 and 2022 were reviewed. Demographic varibles as well as clinical and radiographic outcomes were collected. Ingrowth central peg and noningrowth pegged glenoid groups were compared using t-test, Mann-Whitney U, Chi-Square, or Fisher's exact tests where indicated.

Results: Overall, 49 patients were included: 27 underwent revision from noningrowth and 22 from central ingrowth components. Females more commonly had noningrowth components (74% vs. 45%, P = .04) and preoperative external rotation was higher in central ingrowth components (P = .02). Time to revision was significantly earlier in central ingrowth components (2.4 vs. 7.5 years, P = .01). Structural glenoid allografting was required more with noningrowth components (30% vs. 5%, P = .03) and time to revision in patients ultimately requiring allograft reconstruction was significantly later (9.96 vs. 3.68 years, P = .03).

Conclusion: Central ingrowth pegs on glenoid components were associated with decreased need for structural allograft reconstruction during revision; however, time to revision was earlier in these components. Further research should focus on whether glenoid failure is due to glenoid component design, time to revision, or both.

Keywords: Central ingrowth glenoid; Noningrowth pegged glenoid; Reverse total shoulder arthroplasty; Revision shoulder arthroplasty; Revisions reverse total shoulder arthroplasty; Shoulder arthroplasty; Total shoulder arthroplasty.