Glenoid Design in Total Shoulder Arthroplasty
The use of either keeled or pegged all polyethylene cemented glenoid components are options when performing total shoulder arthroplasty.
LIMITED RECOMMENDATION Rationale
Studies have demonstrated that total shoulder arthroplasty provides improved outcomes in terms of pain relief and function (see Recommendation 7). The concept of performing a pegged or keeled glenoid has been studied extensively from a biomechanical standpoint, but limited data has been available regarding the clinical outcome, durability, and component stability when comparing the two types of resurfacing designs. As such, design considerations have long been considered an important variable when applied to the glenoid component.
One study29 has evaluated the objective outcome and implant stability when comparing the keeled and pegged implant. The authors revealed there was no statistically significant difference between the designs in terms of pain relief and functional improvement in patients following total shoulder arthroplasty. The radiostereometric analysis performed at regular intervals during a two-year follow-up demonstrated greater micromotion in the keeled design group. Although this did not have an impact on short-term outcomes, this may suggest long-term implications with regards to implant loosening and progressive clinical symptoms.
One study29 has evaluated the objective outcome and implant stability when comparing the keeled and pegged implant. The authors revealed there was no statistically significant difference between the designs in terms of pain relief and functional improvement in patients following total shoulder arthroplasty. The radiostereometric analysis performed at regular intervals during a two-year follow-up demonstrated greater micromotion in the keeled design group. Although this did not have an impact on short-term outcomes, this may suggest long-term implications with regards to implant loosening and progressive clinical symptoms.