Comparison of Press Fit Versus Peripherally Cemented Hybrid Glenoid Components in Anatomic Total Shoulder Arthroplasty: Minimum 5-year Follow-up

Abstract Background A common complication of anatomic total shoulder arthroplasty (aTSA) is aseptic glenoid loosening. Monoblock polyethylene glenoid components with backside ingrowth or on-growth utilize hybrid fixation, with cementation of the peripheral pegs and central ingrowth or on-growth of bone have been designed to decrease glenoid loosening. However, there is a paucity of mid-term data comparing cementation of the peripheral peg holes versus all press-fit implantation for hybrid glenoid constructs. The purpose of this study is to compare the minimum five year clinical and radiographic outcomes of a press fit hybrid glenoid component to a peripherally cemented hybrid glenoid component in aTSA. Methods Between years 2013-2015, we reviewed a total of 169 primary aTSA patients, with follow-up data spanning a minimum of five years, from an international multi-institutional database. There were 61 press-fit and 108 peripherally cemented glenoids. Shoulders were evaluated for outcome measures, which included clinical outcome scores, radiographic outcomes, and complication rates. Results Postoperatively, there were no statistically significant differences in patient satisfaction, shoulder function, pain scoring, the Simple Shoulder Test, the Constant score, the American Shoulder and Elbow Surgeons score, the University of California–Los Angeles score, nor the Shoulder Pain and Disability Index, between the two cohorts. There were no significant differences in adverse events (p=0.791) or revision rates (p=0.592). At final radiographic follow-up there were no significant differences between the two groups with regards to the incidence of radiolucent lines on the glenoid (p=0.210) or humeral side (p=0.282). Conclusion At a minimum of 5-year follow-up, aTSA with a press fit glenoid implant demonstrates no difference in clinical or radiographic outcomes when compared to a glenoid cohort where the peripheral pegs are cemented. Additionally, there is no increased rate of aseptic glenoid loosening or need for revision surgery between the two groups with a lower rate of radiolucency detected compared to prior mid-term data studies. Uncemented press fit glenoid fixation with a cage component appears to be a safe and effective treatment option for patients undergoing primary aTSA at a minimum of 5-year follow-up.