One and two-year clinical outcomes for a polyethylene glenoid with a fluted peg: one thousand two hundred seventy individual patients from eleven centers
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Clinical shoulder science lacks a benchmark against which the early clinical value of new glenoid components can be compared; such a benchmark may be derived from a multicenter study of patients receiving an established, internationally used design of glenoid component.
We obtained data from 11 centers on 1270 patients having total shoulder arthroplasty using an all-polyethylene component with a fluted central peg. We analyzed individual patient outcomes at 1 and 2 years after surgery. We compared the improvement for each patient to the minimal clinically important difference (MCID) and calculated each patient’s improvement as a percent of maximal possible improvement (MPI).
The preoperative scores improved from SST 3 ± 2, ASES 37 ± 15, Constant score 36 ± 16, and Penn score 30 ± 19 to SST 10 ± 2, ASES 90 ± 12, Constant 76 ± 13, and Penn 80 ± 24 (p < 0.001 for each). A high percentage of patients improved by more than the MCID (SST 96%, ASES 98%, Constant 94%, Penn 93%) and obtained improvement of at least 30% of the MPI (SST 95%, ASES 98%, Constant 91%, Penn 87%). The clinical outcomes realized with this glenoid design were not worse for the 41% of shoulders with preoperative type B glenoids or for the 30% of shoulders with more than 15 degrees of glenoid retroversion.
Individual patients from 11 international practices having total shoulder arthroplasty using a basic glenoid component design obtained highly significant clinical outcomes, providing a benchmark against which the early outcomes of new designs can be compared to determine whether they provide increased clinical value.
KeywordsGlenoid Ingrowth All-polyethylene Peg Clinical outcomes Minimal clinically important difference Percentage of maximal possible improvement
We thank Susan DeBartolo, University of Washington, Department of Orthopaedics and Sports Medicine, (blinded for review purposes) for her editorial work on this manuscript.
There was no extramural funding for this investigation.
Compliance with ethical standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This was a retrospective cohort study approved by our Institutional Review Board (HSD# STUDY00001714). For this type of study, formal consent is not required.
Conflict of interest
Financial remuneration the authors, or any member of their family, may have received directly related to the subject of the article: none.
The following is blinded for review purposes:
Dr. Matsen (first and corresponding author), Dr. De Wilde, Dr. Groh, Dr. Kilian, Dr. Merolla, Mr. Neradilek, Dr. Porcellini, Ms. Russ, Dr. Somerson, and Dr. Vidil have no conflict of interests to report.
The following doctors have conflict of interests outside of the submitted work as noted:
Dr. Iannotti reports personal fees from DePuy Synthes, personal fees from DJO Surgical, personal fees from Wright Tornier, from null, outside the submitted work.
Dr. Churchill reports personal fees from Wright Medical Tornier, Inc., during the conduct of the study; personal fees from Wright Medical Tornier, Inc., outside the submitted work. In addition, Dr. Churchill has a patent Glenoid Anchor Post licensed to Tornier Inc.
Dr. Edwards reports personal fees and non-financial support from Wright Medical Inc., during the conduct of the study; personal fees and non-financial support from Wright Medical Inc., outside the submitted work; and royalties and consulting fees from Wright Medical Inc. & DJO.
Dr. Evans reports other from DePuy-Johnson and Johnson, outside the submitted work.
Dr. Fehringer reports grants from University of Nebraska Medical Center, other from Wright Medical, during the conduct of the study.
Dr. Kelly reports other from Wright Medical, during the conduct of the study; personal fees and other from Wright Medical, outside the submitted work.
Dr. Norris reports personal fees and other from Wright Medical, during the conduct of the study.
Dr. Spencer reports personal fees from Tornier/Wright, outside the submitted work.
Dr. Wirth reports other from DePuy-Johnson and Johnson, other from Wright Medical, other from Elsevier, grants from Arthrex, outside the submitted work. In addition, Dr. Wirth has a patent with royalties paid.
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