Assessing the required glenoid peg penetration in native scapula when bone graft is used during primary and revision shoulder arthroplasty

Author:

Makki Daoud1,Balbisi Basel2ORCID,Arshad Mohammed S3,Monga Puneet4,Bale Steven5,Trail Ian5,Walton Michael6

Affiliation:

1. St Helens and Knowsley University Hospitals, Prescot, UK

2. Trauma and Orthopaedics, West Hertfordshire Hospitals NHS Trust, Watford, UK

3. Trauma & Orhopaedics, Salford Royal NHS Foundation Trust, Wrightington Hospital, Wigan, UK

4. Upper Limb Unit, Wrightington Hospital, Wigan, UK

5. Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK

6. Trauma and Orthopaedics, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK

Abstract

Aims Achieving purchase in native glenoid bone is essential for the stability of the glenoid baseplate when bone graft is used to address bone loss in both primary and revision shoulder arthroplasty procedures. The aim of this study is to assess the required depth of the baseplate peg in native bone when bone graft is used to result in satisfactory integration. Patients and methods The CT scans of patients who underwent either primary or revision arthroplasty procedures with bone graft using the SMR Axioma Trabecular Titanium (TT) Metal Backed glenoid system were assessed. We measured the depth of the glenoid peg in native glenoid bone. Measurements were taken by two authors separately. Results The scans of 53 patients (mean age 68 years) with a minimum follow-up of two years were reviewed. Implants included 12 anatomical and 41 reverse geometry prostheses. There were 17 primaries and 36 revisions: hemiarthroplasties (20) total (14) and reverse (2) implants. Bone grafts were from humeral head (15), iliac crest (34) and allograft (4). The mean depths were 8.8 mm (first assessor) and 9.10 mm (second assessor). The glenoid peg violated the glenoid vault in 32 patients and this did not adversely affect the outcome. There were three failures of implants all of which were aseptic failures and had peg penetration of less than 6 mm. Conclusions The mean depth of glenoid peg in native bone was 9 mm (variation between 0.2 and 0.52 mm at 95% confidence interval). Aseptic loosening was seen with peg penetration less than 6 mm in native bone. Glenoid vault violation was not associated with loosening.

Publisher

SAGE Publications

Subject

Rehabilitation,Physical Therapy, Sports Therapy and Rehabilitation,Orthopedics and Sports Medicine,Surgery

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