Survival of the glenoid component in shoulder arthroplasty

Introduction: This study was conducted to determine the survival of different glenoid component designs, assess the reasons for revision Surgery, and identify patient and diagnostic factors that influence this need. Methods: Between January 1, 1984, and December 31, 2004, 1337 patients underwent 1542 total shoulder arthroplasties with 6 types of glenoid components: Neer 11 all-polyethylene, Neer II metal-backed, Cofield 1 metal-backed bone-ingrowth, Cofield I all-poly keeled, Cofield 2 all-poly keeled, and Cofield 2 all-poly pegged. Results: Revision was required in 125 shoulders for glenoid component failure. Survival rates free of revision by glenoid implant type at 5, 10, and 15 years were, respectively, 96%, 96%, and 95% for 99 Neer 11 all-poly; 96%, 94%, and 89% for 316 Neer 11 metal-backed; 86%, 79%, and 67% for 316 Cofield 1 metal-backed; 94%, 94%, and 87% for 18 Cofield I all-poly; 99%, 94%, and 89% for 497 Cofield 2 all-poly keeled; and 99% at 5 years for 358 Cofield 2 all-poly pegged. Glenoid component type was significantly associated with component revision (P < .001). Male gender was associated with a higher risk of revision (P < .001). Compared with degenerative arthritis, posttraumatic arthritis (P = .02) and avascular necrosis (P = .06.) were associated with increased risk of revision. Conclusions: Survival is improved with cemented all-polyethylene glenoid components. Revision of cemented all-polyethylene components may be lessened with the use of pegged components in early follow-up. Male gender and the operative diagnoses of posttraumatic arthritis or avascular necrosis are associated with an increased risk of failure. Level of Evidence: Level IV, Case Series, Treatment Study (C) 2009 Journal of Shoulder and Elbow Surgery Board of Trustees.