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Abstract

Background

A number of papers have been published reporting on the clinical performance of modern trabecular metal-backed glenoid components in total shoulder arthroplasty. However, no systematic review of the literature has been published to date.

Methods

The US National Library of Medicine (PubMed/MEDLINE), and the Cochrane Database of Systematic Reviews and EMBASE were queried for publications from January 1980 to October 2019 utilizing keywords pertinent to total shoulder arthroplasty, trabecular metal, and clinical outcomes.

Results

Overall, seven articles were included for analysis (322 operated shoulders, mean follow-up range: 2–4 years). The survival rate of modern trabecular metal-backed glenoid components was 96% (309 out of 322 cases) at 43 months mean follow-up, while the rate of aseptic loosening was 0.3% (1 out of 322 cases). There were 35 cases (10.9%) with glenoid component radiolucency (one of them required revision), and 37 cases (11.5%) of metal debris formation, with four of them undergoing revision.

Conclusions

There was low quality evidence to show that the use of modern trabecular metal-backed glenoid components in total shoulder arthroplasty may be safe and effective at short-term follow-up. However, this analysis showed alarmingly high rates of both radiolucency of the glenoid component and metal debris formation which raise concern for potential failure of this glenoid component in the long term. Therefore, we feel that modern trabecular metal-backed glenoid components should be still used with caution as part of a structured surveillance or research program until we know if there is a detriment to the prosthesis in the medium to long term.

Level: Systematic review, IV.

Keywords

Highly porous glenoid metal-backed glenoid component systematic review tantalum glenoid total shoulder arthroplasty trabecular metal glenoid

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References

Pinkas

Wiater

. The glenoid component in anatomic shoulder arthroplasty. J Am Acad Orthop Surg 2015; 23: 317–326.

Frankle

Levy

Pupello

, et al. The reverse shoulder prosthesis for gleno-humeral arthritis associated with severe rotator cuff deficiency: a minimum two-year follow-up study of sixty patients: surgical technique. J Bone Joint Surg Am 2006; 88: 178–190.

Papadonikolakis

Neradilek

Matsen

3rd . Failure of the glenoid component in anatomic total shoulder arthroplasty: a systematic review of the English-language literature between 2006 and 2012. J Bone Joint Surg Am 2013; 95: 2205–2212.

Andreykiv

Prendergast

van Keulen

, et al. Bone ingrowth simulation for a concept glenoid component design. J Biomech 2005; 38: 1023–1033.

Tammachote

Sperling

Vathana

, et al. Long-term results of cemented metal-backed glenoid components for osteoarthritis of the shoulder. J Bone Joint Surg Am 2009; 91: 160–166.

Walch

Young

Melis

, et al. Results of a convex-back cemented keeled glenoid component in primary osteoarthritis: multicenter study with a follow-up greater than 5 years. J Shoulder Elbow Surg 2011; 20: 385–394.

Papadonikolakis

Matsen

3rd . Metal-backed glenoid components have a higher rate of failure and fail by different modes in comparison with all-polyethylene components: a systematic review. J Bone Joint Surg Am 2014; 96: 1041–1047.

Page

Pai

Eng

, et al. Cementless versus cemented glenoid components in conventional total shoulder joint arthroplasty: analysis from the Australian Orthopaedic Association National Joint Replacement Registry. J Shoulder Elbow Surg 2018; 27: 1859–1865.

Clitherow

Frampton

Astley

. Effect of glenoid cementation on total shoulder arthroplasty for degenerative arthritis of the shoulder: a review of the New Zealand National Joint Registry. J Shoulder Elbow Surg 2014; 23: 775–781.

10.

Kontakis

Koutras

Tosounidis

, et al. Early management of proximal humeral fractures with hemiarthroplasty: a systematic review. J Bone Joint Surg Br 2008; 90: 1407–1413.

11.

Dunbar

Wilson

Hennigar

, et al. Fixation of a trabecular metal knee arthroplasty component. A prospective randomized study. J Bone Joint SurgAm 2009; 91: 1578–1586.

12.

Meneghini

Ford

McCollough

, et al. Bone remodeling around porous metal cementless acetabular components. J Arthroplasty 2010; 25: 741–747.

13.

Kuboki

Takita

Kobayashi

, et al. BMP-induced osteogenesis on the surface of hydroxyapatite with geometrically feasible and non feasible structures: topology of osteogenesis. J Biomed Mater Res 1998; 39: 190–199.

14.

Karageorgiou

Kaplan

. Porosity of 3D biomaterial scaffolds and osteogenesis. Biomaterials 2005; 26: 5474–5491.

15.

Budge

Kurdziel

Baker

, et al. A biomechanical analysis of initial fixation options for porous-tantalum-backed glenoid components. J Shoulder Elbow Surg 2013; 22: 709–715.

16.

Jones

Arns

Sheppard

, et al. Assessment of bone ingrowth into porous biomaterials using MICRO-CT. Biomaterials 2007; 28: 2491–2504.

17.

Stange

Kelly

Chao

, et al. Physician agreement with US Preventive Services Task Force recommendations. J Fam Pract 1992; 34: 409–416.

18.

Coleman

Khan

Maffulli

, et al. Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Victorian Institute of Sport Tendon Study Group. Scand J Med Sci Sports 2000; 10: 2–11.

19.

Styron

Marinello

Peers

, et al. Survivorship of trabecular metal anchored glenoid total shoulder arthroplasties. Tech Hand Up Extrem Surg 2016; 20: 113–116.

20.

Obermeyer

Cagle

Jr Parsons

, et al. Midterm follow-up of metal-backed glenoid components in anatomical total shoulder arthroplasties. Am J Orthop 2015; 44: E340–E342.

21.

Merolla

Chin

Sasyniuk

, et al. Total shoulder arthroplasty with a second-generation tantalum trabecular metal-backed glenoid component: clinical and radiographic outcomes at a mean follow-up of 38 months. Bone Joint J 2016; 98-B: 75–80.

22.

Panti

Tan

Kuo

, et al. Clinical and radiologic outcomes of the second-generation Trabecular Metal™ glenoid for total shoulder replacements after 2–6 years follow-up. Arch Orthop Trauma Surg 2016; 136: 1637–1645.

23.

Endrizzi

Mackenzie

Henry

. Early debris formation with a porous tantalum glenoid component: radiographic analysis with 2-year minimum follow-up. J Bone Joint Surg Am 2016; 98: 1023–1029.

24.

Budge

Nolan

Heisey

, et al. Results of total shoulder arthroplasty with a monoblock porous tantalum glenoid component: a prospective minimum 2-year follow-up study. J Shoulder Elbow Surg 2013; 22: 535–541.

25.

Watson

Gudger

Jr Long

, et al. Outcomes of trabecular metal-backed glenoid components in anatomic total shoulder arthroplasty. J Shoulder Elbow Surg 2018; 27: 493–498.

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Modern trabecular metal-backed glenoid components in total shoulder arthroplasty: What is the evidence? A systematic review