Fox and colleagues used the Mayo Clinic joint registry to compare revision‑free survival of six glenoid component designs and to find the patient and diagnostic factors linked to revision.
Single‑institution registry series of 1542 primary TSAs in 1337 patients, 1984 to 2004, followed for a mean of 7.2 years. Level IV.
Key Findings
The Cofield 1 bone‑ingrowth metal‑backed glenoid fared worst, with revision‑free survival of 86% at 5 years, 79% at 10 and 67% at 15 years.
Wear caused revision only in the two metal‑backed designs, and instability almost only in the Cofield 1 metal‑backed glenoid (20 of its 74 revisions).
Cemented all‑polyethylene glenoids combined had revision‑free survival of 98% at 5 years, 95% at 10 and 92% at 15 years. Aseptic loosening was their most common reason for revision.
Pegged all‑polyethylene glenoids had 99% survival at 5 years, an early advantage the authors call slight and did not test. Their mean follow‑up was only 2.3 years.
Men had a higher revision risk than women (multivariable HR 2.2, 95% CI 1.4 to 3.3), with 15‑year survival of 76% vs 92%. Age 65 or older was not a significant factor.
Relative to degenerative arthritis, posttraumatic arthritis raised revision risk (HR 1.8, p = 0.02). The higher risk with avascular necrosis (HR 2.7, p = 0.06) did not reach significance.
Authors' conclusion
Survival is improved with cemented all-polyethylene glenoid components. Revision of cemented all-polyethylene components may be lessened with the use of pegged components in early follow-up. Male gender and the operative diagnoses of posttraumatic arthritis or avascular necrosis are associated with an increased risk of failure.
Fox and colleagues used the Mayo Clinic joint registry to compare revision‑free survival of six glenoid component designs and to find the patient and diagnostic factors linked to revision.
Single‑institution registry series of 1542 primary TSAs in 1337 patients, 1984 to 2004, followed for a mean of 7.2 years. Level IV.
Key Findings
The Cofield 1 bone‑ingrowth metal‑backed glenoid fared worst, with revision‑free survival of 86% at 5 years, 79% at 10 and 67% at 15 years.
Wear caused revision only in the two metal‑backed designs, and instability almost only in the Cofield 1 metal‑backed glenoid (20 of its 74 revisions).
Cemented all‑polyethylene glenoids combined had revision‑free survival of 98% at 5 years, 95% at 10 and 92% at 15 years. Aseptic loosening was their most common reason for revision.
Pegged all‑polyethylene glenoids had 99% survival at 5 years, an early advantage the authors call slight and did not test. Their mean follow‑up was only 2.3 years.
Men had a higher revision risk than women (multivariable HR 2.2, 95% CI 1.4 to 3.3), with 15‑year survival of 76% vs 92%. Age 65 or older was not a significant factor.
Relative to degenerative arthritis, posttraumatic arthritis raised revision risk (HR 1.8, p = 0.02). The higher risk with avascular necrosis (HR 2.7, p = 0.06) did not reach significance.
Authors' conclusion
Survival is improved with cemented all-polyethylene glenoid components. Revision of cemented all-polyethylene components may be lessened with the use of pegged components in early follow-up. Male gender and the operative diagnoses of posttraumatic arthritis or avascular necrosis are associated with an increased risk of failure.