Total shoulder arthroplasty with hybrid fixation of glenoid components consisting of cementless porous metal pegs or cage along with cemented backside polyethylene surface: a systematic review

Abstract

Recently, hybrid glenoid components have been developed, consisting of cementless highly porous metal central peg, monoblock keel or cage along with cemented backside polyethylene surface. The aims of this study were twofold: (1) to determine the revision and complication rates of hybrid glenoid components, consisting of porous metal pegs or coatings attached to the polyethylene, for aseptic loosening in TSA and (2) to evaluate the rate of radiolucent lines in patients who underwent TSA with hybrid glenoid components consisting of porous metal pegs or coatings attached to the polyethylene. The US National Library of Medicine (PubMed/MEDLINE), EMBASE and the Cochrane Database of Systematic Reviews were queried for publications utilizing the following keywords: “hybrid” OR “bone-ingrowth” OR “bone ingrowth” AND “TSA” OR “total” AND “shoulder” AND “arthroplasty” OR “replacement”. Five articles were included for analysis (470 operated shoulders, mean follow-up: 47.5 months). The overall weighted mean modified methodology Coleman score was 51.2/100, indicating a moderate level of overall methodological quality. The survival rate of hybrid glenoid components was 97.4% (458 out of 470 cases), while the rate of glenoid-related complications was 2.8% (13 cases). Finally, there were 54 cases (out of 313 reported; 17.3%) with glenoid radiolucency (none of them required revision). TSA with hybrid fixation glenoid components was associated with high survivorship and low rate of glenoid component-related complications at 4 years mean follow-up. In addition, there was limited evidence to show that the short- to mid-term outcome of TSA using hybrid glenoid components is not inferior to the outcome of cemented all-polyethylene glenoid components.

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Correspondence to I. Gkiatas.

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Malahias, M., Kostretzis, L., Gkiatas, I. et al. Total shoulder arthroplasty with hybrid fixation of glenoid components consisting of cementless porous metal pegs or cage along with cemented backside polyethylene surface: a systematic review. Musculoskelet Surg (2020). https://doi.org/10.1007/s12306-020-00670-y

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Keywords

  • Total shoulder arthroplasty
  • Hybrid fixation
  • Glenoid