Metal-backed glenoid implant with XXXX insert is not a viable long-term therapeutic option.

@entity691 @entity1 @entity571 @entity3356 @entity604 @entity3061
BACKGROUND: The aims of this study were to determine the survival of anatomic total shoulder arthroplasty with uncemented metal-backed (MB) glenoid components with a @entity691 (PE) insert in @entity571 , to assess the reasons for revision surgery, and to identify @entity1 and diagnostic factors that influence failure rates. METHODS: Between 1994 and 1999, 165 @entity1 (mean age, 68  years) with @entity571 were treated with anatomic total shoulder arthroplasty using an uncemented MB/PE glenoid component. Outcomes were assessed both clinically and radiologically with a minimum of 2  years of follow-up. A prosthetic survival curve was constructed with the end point defined as either partial or complete revision, using 100% confidence intervals. RESULTS: Survival rate free of revision was 46% (100% confidence interval, 32%-54%) at 12  years. At a mean follow-up of 8.5  years (range, 2-16  years), revision was required in 61 @entity1 (37%); 80% of shoulders undergoing revision (49 of 61) had evidence of PE wear. Glenoid loosening (because of @entity3061 secondary to @entity3356 ), soft tissue deficiency, and prosthetic instability were the most common modes of failure. Younger @entity1 and biconcave glenoids (with posterior humeral subluxation) have a negative effect on implant survival. Proximal humerus @entity3061 was significantly more frequent in shoulders with PE wear. Exchange of the PE insert (with conservation of the MB tray) was possible in only 3% of the revised shoulders. CONCLUSION: Uncemented MB glenoid resurfacing is not a viable long-term therapeutic option because of accelerated PE wear leading to early revision surgery. Conservation of the MB tray with reinsertion of a new PE insert is rarely possible because of glenoid @entity604 , implant loosening, soft tissue deficiency, and prosthetic instability. Younger @entity1 and biconcave glenoids have a negative effect on implant survival.
