Department of Orthopaedics, Mayo Clinic, Rochester, MN 55905, USA.
J Shoulder Elbow Surg. 2010 Jul;19(5):726-33. doi: 10.1016/j.jse.2009.10.018. Epub 2010 Feb 10.
Loosening of the glenoid component is a common complication in shoulder arthroplasty. We proposed to radiographically and clinically investigate the outcomes of keeled and pegged glenoid components to test the hypothesis that these implants would have equivalent performance.
One hundred patients undergoing primary shoulder arthroplasty for osteoarthritis were reviewed. Fifty patients had pegged glenoid components, and fifty had keeled components. Standardized radiographs were taken. Preoperative films classified the severity of degenerative change. The postoperative films were analyzed for radiolucent lines and shift in component position-at-risk signs for loosening.
Mean radiographic follow-up was 51.3 months (range, 24-90 months) for the keeled group and 45.7 months (range, 27-98 months) for the pegged group. There were no differences in the degree of preoperative arthritic change between groups. Both groups had significant improvement in motion and pain (P < .001) postoperatively, with no differences in clinical outcome between cohorts (P > or = .20). Initial radiographs showed no radiolucencies around the pegs in 46 implants or around the keel in 49 components. At final follow-up, 10 glenoid implants were found to be at risk for loosening, 6 (12%) in the pegged group and 4 (8%) in the keeled group (P = .74).
Initial postoperative radiographs with pegged and keeled components show a low rate of radiolucent lines. These radiolucencies develop over time. However, there is no difference in clinical or radiographic outcomes between pegged and keeled components at intermediate-term follow-up.
在肩关节置换术中，肩胛盂部件松动是一种常见的并发症。我们提出对有和无钉槽的肩胛盂部件进行影像学和临床研究，以检验这些植入物具有等效性能的假设。
回顾了 100 例因骨关节炎行初次肩关节置换术的患者。50 例患者使用了带钉槽的肩胛盂部件，50 例患者使用了带翼的肩胛盂部件。拍摄了标准的 X 线片。术前 X 线片评估退行性改变的严重程度。术后 X 线片分析了透亮线和肩胛盂部件位置变化的情况——这些都是松动的高危征象。
带翼组的平均影像学随访时间为 51.3 个月（范围，24-90 个月），带钉槽组为 45.7 个月（范围，27-98 个月）。两组患者术前的关节炎改变程度无差异。两组患者术后在运动和疼痛方面均有显著改善（P<0.001），两组间临床结果无差异（P≥0.20）。初始 X 线片显示 46 个植入物的钉周围和 49 个组件的翼周围均无透亮线。在最终随访时，发现 10 个肩胛盂植入物有松动的风险，其中带钉槽组 6 个（12%），带翼组 4 个（8%）（P=0.74）。
带钉槽和带翼肩胛盂组件的初始术后 X 线片显示透亮线的发生率较低。这些透亮线会随时间而发展。然而，在中期随访时，带钉槽和带翼组件在临床和影像学结果方面没有差异。
