One and two-year clinical outcomes for a polyethylene glenoid with a fluted peg: one thousand two hundred seventy individual patients from eleven centers

• Published in: International orthopaedics Vol. 43; no. 2; pp. 367 - 378
• Main Authors: Matsen, Frederick A., Iannotti, Joseph P., Churchill, R. Sean, De Wilde, Lieven, Edwards, T. Bradley, Evans, Matthew C., Fehringer, Edward V., Groh, Gordon I., Kelly, James D., Kilian, Christopher M., Merolla, Giovanni, Norris, Tom R., Porcellini, Giuseppe, Spencer, Edwin E., Vidil, Anne, Wirth, Michael A., Russ, Stacy M., Neradilek, Moni, Somerson, Jeremy S.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2019
• Subjects: Medicine; Medicine & Public Health; Original Paper; Orthopedics; Peg; Percentage of maximal possible improvement; Glenoid; Ingrowth; All-polyethylene; Clinical outcomes; Minimal clinically important difference
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-018-4213-3

Purpose 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. Methods 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). Results 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. Conclusions 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.