Abstract
The metal backed glenoid component in total shoulder replacement (TSR) has been associated with high revision rates and some authors have suspended the use of this implant.
The aim of this study was to evaluate the medium to long-term outcome of the metal backed glenoid component in rheumatoid patients.
Thirty-nine patients (46 shoulders) with a mean age of 55 years (35–86 years) received a TSR with a screw fixed porous coated metal-back glenoid. Ten were lost or died before 8 years follow-up, of which none were revised. Twenty-nine patients (36 shoulders) were followed up for a mean of 132 months (96–168 months). A Constant score was measured preoperatively and annually from time of surgery, and independently at last follow-up. Radiographs were assessed for lucency, loosening and superior subluxation of the humeral head.
The Constant score improved by 12.9 points (p=< 0.001). Implant survivorship at 10 years was 89%. Five were revised: 3 for pain secondary to superior subluxation, one for infection and one for aseptic loosing. All patients with lucent zones around the glenoid (four) had superior subluxation of the humeral head two to four years prior to their development. Survival rate however at 10 years was reduced, if judged by the development of superior subluxation on radiographs (33%).
The uncemented glenoid performs well in the rheumatoid shoulder, giving pain relief and improved functional outcome. The survivorship is comparable to previously reported studies.
The abstracts were prepared by Mr Matt Costa and Mr Ben Ollivere. Correspondence should be addressed to Mr Costa at Clinical Sciences Research Institute, University of Warwick, Clifford Bridge Road, Coventry CV2 2DX, UK.
