Table 1. Demographic data and outcome measurement of individual studies
Cemented all-polyethylene glenoid components (PEG)
|
Authors
|
Level of Evidence
|
Design
|
Cases
|
Mean age
(y, range)
|
Mean FU
(m, range)
|
Range of motion
|
Outcome measurements
|
Raiss (2008)
|
IV
|
Aequalisa
|
21
|
55 (37–60)
|
7 years (5–9)
|
FE, ABD, IR, ER
|
Constant score
|
Rice (2008)
|
IV
|
Cofield IIb
|
14
|
66 (52–78)
|
5 years (2–8)
|
ABD, ER
|
Neer result rating
|
Fox (2009)
|
IV
|
Mixedc
|
972
|
66.4
|
68.1
|
N
|
N
|
Edwards (2010)
|
I
|
Aequalisa
|
47
|
69 ± 11
|
26 (12–38)
|
N
|
N
|
Throckmorton (2010)
|
III
|
Cofield
|
100
|
68.6 (52–80)
|
48.5 (24–98)
|
FE, IR, ER
|
VAS
|
Arnold (2011)
|
IV
|
Global Advantaged
|
35
|
70 (49–89)
|
43 (24–66)
|
N
|
Constant score
|
Collin (2011)
|
II
|
Aequalisa
|
56
|
66.7 (43–83)
|
120 (102–155)
|
N
|
N
|
Walch (2011)
|
IV
|
Aequalisa
|
333
|
69.3 (35–90)
|
89.5 (61–152)
|
FE, ER
|
Constant score
|
Young (2011)
|
IV
|
Aequalisa
|
226
|
66.9 (40–90)
|
122.7 (61–219)
|
FE, ER
|
Constant score
|
Raiss (2012)
|
IV
|
Aequalisa
|
39
|
64 (43–79)
|
132 (120–180)
|
FE, ABD, IR, ER
|
Constant score
|
Wirth (2012)
|
IV
|
Global Advantaged
|
44
|
66 (52–79)
|
48 (24–84)
|
FE, IR, ER
|
VAS, ASES score, SST
|
Denard (2013)
|
IV
|
Aequalisa
|
50
|
50.5 (35–55)
|
115.5 (60–211)
|
FE, ER
|
Constant score
|
Greiner (2013)
|
IV
|
Affinise
|
97
|
66.6 (30–85)
|
58.8 (31.2–92.5)
|
FE, ABD
|
Constant score
|
Raiss (2014)
|
IV
|
N (mixed)
|
329
|
N
|
8.0 years (4–17)
|
FE, ER
|
Constant score
|
Gazielly (2015)
|
IV
|
Aequalisa
|
39
|
68.1 (51–81)
|
102 ( 56.4–150)
|
FE, ER
|
Constant score, pain score
|
Gulotta (2015)
|
III
|
BioModularf
|
40
|
68.2 ± 9.1
|
38 (24–45)
|
N
|
VAS, ASES
|
Noyes (2015)
|
IV
|
Global Advantaged
|
42
|
64 (51–80)
|
80 (63–114)
|
FE, ER
|
ASES
|
Wright (2015)
|
IV
|
Equinoxeg
|
24
|
66.4 ± 9.1
|
29.6 ± 8.7
|
FE, ABD, IR, ER
|
Constant score, ASES, SST, UCLA
|
Parks (2016)
|
IV
|
Affinitih
|
76
|
63.5 (39–86)
|
28.7 (24–60)
|
FE, ABD, IR, ER
|
Constant score, ASES
|
Wijeratna (2016)
|
IV
|
Global Advantaged
|
83
|
68.6 (49–88)
|
46.7 (24–99)
|
FE, IR, ER
|
ASES, Oxford score
|
McLendon (2017)
|
IV
|
Cofield IIi
|
287
|
65 (21–85)
|
84 (48–171.6)
|
N
|
N
|
Service (2017)
|
III
|
Global Advantaged
|
71
|
68 ± 8.3
|
30 ± 7.2
|
N
|
SST
|
Gauci (2018)
|
III
|
Aequalisa
|
46
|
55(40–60)
|
123.6 ± 26 (60–144)
|
FE, ER
|
VAS, Constant score, SSV
|
Raiss (2018)
|
IV
|
Aequalisj
|
118
|
68 (51–85)
|
38 (24–70)
|
N
|
N
|
Sanchez-Sotelo (2018)
|
2018/IV
|
PEG
|
202
|
67 (24–93)
|
32.4 (24–60)
|
FE, IR, ER
|
ASES
|
Modern design of metal-backed glenoid component (MBG)
|
Authors
|
Level of Evidence
|
Design
|
Cases
|
Mean age
(y, range)
|
Mean FU
(m, range)
|
Range of motion
|
Outcome measurements
|
Castagna (2010)
|
IV
|
Second-generation SMRl
|
35
|
62.7 (55.3–70.1)
|
75.4
|
N
|
VAS, Constant score, SST
|
Fucentese (2010)
|
IV
|
Sulmeshm
|
22
|
68.5 (49–84)
|
50 (24–89)
|
N
|
Constant score
|
Budge (2013)
|
IV
|
Tantalum TMn
|
19
|
62.8 ± 14.6
|
31 (24–64)
|
ER
|
VAS, ASES score
|
Styron (2016)
|
IV
|
Tantalum TMn
|
66
|
66.2 (31–88)
|
50.2
|
FE, IR, ER
|
N
|
Sandow (2016)
|
IV
|
Tantalum TMn
|
10
|
(60–79)
|
24
|
FE
|
VAS, Oxford score, ASES score
|
Panti (2016)
|
IV
|
Tantalum TMn
|
76
|
69.6 (52–81)
|
43.2 (24–72)
|
FE, ABD, ER
|
VAS, ASES score
|
Endrizzi (2016)
|
IV
|
Tantalum TMn
|
73
|
67.5 ± 8.6 (46–85)
|
50.8 (24–68)
|
N
|
VAS, ASES score
|
Merolla (2016)
|
IV
|
Tantalum TMn
|
40
|
63.8 (40–75)
|
38 (24–42)
|
FE, ABD, ER
|
Health state, Constant score, ASES score
|
Gurin (2017)
|
IV
|
Tantalum TMn
|
80
|
N
|
100
|
N
|
VAS
|
Watson (2018)
|
IV
|
Tantalum TMn
|
36
|
66.36 (50–85)
|
34.1 (23–61)
|
FE, ER
|
VAS, SANE score, Penn score, ASES score
|
Common outcome measurements
|
Radiolucency, loosening, complication, and revision surgery (failure)
|
N, not recorded; y, year; m, month; FU, follow-up; FE, forward elevation; ABD, abduction; IR, internal rotation; ER, external rotation; VAS, visual analogue scale; ASES, American shoulder and elbow surgeons; SST, simple shoulder test; SF-12, short form-12; UCLA, University of California at Los Angeles; SSV, subjective shoulder value; SANE, single alpha-numeric evaluation
a Unconstrained, cemented, third-generation implant (Aequalis Primary Shoulder Prosthesis; Tornier Inc., Edina, Minnesota, USA) or Aequalis prosthesis (Tornier, Mont Bonnot, France)
b Cofield 2 keeled all-polyethylene cemented components with a posterior augmentation (Smith and Nephew, Inc, Memphis, TN, USA)
c Neer II all-polyethylene components (3M, St. Paul, MN; Kirschner Medical Corporation, Fairlawn, NJ; Biomet, Warsaw, IN, USA), Cofield 1 all-polyethylene component, Cofield 2 all-polyethylene keeled, and Cofield 2 all-polyethylene pegged components (Smith & Nephew, Memphis, TN, USA)
d Depuy Global Advantage with an Anchor Peg glenoid (Depuy, Warsaw, IN, USA)
e Affinis shoulder prosthesis (Mathys Ltd Bettlach, Switzerland)
f BioModular Total Shoulder System with an all-polyethylene, cemented, pegged glenoid (Biomet, Inc, Warsaw, IN, USA)
g Equinoxe (Exactech, Inc., Gainesville, FL, USA)
h Affiniti CortiLoc glenoid (Tornier, Inc., Edina, MN, USA)
i Cofield II all-polyethylene pegged component (Smith & Nephew, Memphis, TN, USA)
j Cemented keeled glenoid with different backside radiuses of curvature (Tornier/Wright Medical, Memphis, TN, USA)
k ReUnion (Stryker, Mahwah, NJ, USA)
l Second generation SMR System (Lima Corporate, Villanova, Italy)
m Titanium metal-backed glenoid component (Sulmesh; Zimmer, Winterthur, Switzerland)
n Second-generation porous tantalum trabecular metal glenoid (Zimmer, Warsaw, IN, USA)
Table 2. Clinical outcomes of individual studies
Cemented all-polyethylene glenoid components (PEG)
|
Authors
|
Cases
|
Gain of FE (°)
|
Gain of ER (°)
|
Radiolucency
|
Loosening
|
Revision surgeries
|
Other reoperations
|
Raiss (2008)
|
21
|
50.7
|
28.1
|
10 (48%)
|
10
|
0
|
0
|
Rice (2008)
|
14
|
N
|
21
|
1 (7%)
|
1
|
0
|
0
|
Fox (2009)
|
972
|
N
|
N
|
N
|
15
|
26
|
0
|
Edwards (2010)
|
47
|
N
|
N
|
N
|
0
|
2
|
0
|
Throckmorton (2010)
|
100
|
48.3
|
28.6
|
N
|
10
|
0
|
0
|
Arnold (2011)
|
35
|
N
|
N
|
5
|
0
|
0
|
0
|
Collin (2011)
|
56
|
N
|
N
|
N
|
20
|
3
|
2: RC repair
|
Walch (2011)
|
333
|
51.7 26.3 96
|
26.3
|
96
|
57
|
5
|
3: open contracture release
|
Young (2011)
|
226
|
39.7
|
23.3
|
144
|
99
|
37
|
2: Periprosthetic fracture
3: instability
2: RC repair
2: infection
2: stiffness
|
Raiss (2012)
|
39
|
49
|
24
|
N
|
N
|
1
|
0
|
Wirth (2012)
|
44
|
141.9
|
34.6
|
N
|
N
|
1
|
0
|
Denard (2013)
|
50
|
31
|
21
|
30 of 48
|
21 of 48
|
17
|
0
|
Greiner (2013)
|
97
|
59.6
|
N
|
9
|
3
|
7
|
0
|
Raiss (2014)
|
250
|
46.9
|
25.0
|
N
|
100
|
22
|
0
|
Gazielly (2015)
|
39
|
42.4
|
25.7
|
8
|
6
|
1
|
0
|
Gulotta (2015)
|
40
|
N
|
N
|
N
|
0
|
0
|
1 infection
1 biceps tendinitis
|
Noyes (2015)
|
42
|
30
|
7
|
8
|
N
|
1
|
0
|
Wright (2015)
|
24
|
44.2
|
24.8
|
5 of 15
|
0
|
0
|
0
|
Parks (2016)
|
76
|
31
|
13
|
14
|
1
|
7 of 80
|
N
|
Wijeratna (2016)
|
83
|
N
|
N
|
5
|
1
|
1
|
3 contracture release
1: RC repair
1: capsular plication
|
McLendon (2017)
|
287
|
N
|
N
|
N
|
120
|
36
|
0
|
Service (2017)
|
71
|
N
|
N
|
19
|
1
|
3
|
0
|
Gauci (2018)
|
46
|
40
|
26
|
N
|
10
|
10
|
N
|
Raiss (2018)
|
118
|
N
|
N
|
N
|
0
|
2
|
0
|
Sanchez-Sotelo (2018)
|
202
|
N
|
N
|
0
|
0
|
7
|
2
|
Modern design of metal-backed glenoid component (MBG)
|
Authors
|
Cases
|
Gain of FE (°)
|
Gain of ER (°)
|
Radiolucency
|
Loosening
|
Revision surgeries
|
Other reoperations
|
Castagna (2010)
|
35
|
N
|
N
|
8 (22%)
|
0
|
0
|
0
|
Fucentese (2010)
|
22
|
N
|
N
|
N
|
3 (14%)
|
3 (14%)
|
0
|
Budge (2013)
|
19
|
N
|
44
|
7 (37%)
|
4 (21%)
|
3 (16%)
|
N
|
Styron (2016)
|
66
|
70
|
36
|
N
|
13 of 58 (23%)
|
1 (2%)
|
N
|
Sandow (2016)
|
10
|
N
|
N
|
0
|
0
|
0
|
0
|
Panti (2016)
|
76
|
54.4
|
40.8
|
5 (7%)
|
0
|
0
|
1: RC repair
|
Endrizzi (2016)
|
73
|
N
|
N
|
24 of 66 (36.4%)
|
1 of 66 (1.5%)
|
1 (1%)
|
0
|
Merolla (2016)
|
40
|
N
|
N
|
2 (5%)
|
0
|
0
|
0
|
Gurin (2017)
|
80
|
N
|
N
|
N
|
0
|
2 (3%)
|
0
|
Watson (2018)
|
36
|
N
|
N
|
1 (2.8%)
|
1 (2.8%)
|
1 (3%)
|
N
|
N, not recorded; FE, forward elevation; ER, external rotation; RC, rotator cuff
Table 3. Summary of cemented PEG and modern MBG
|
|
Cemented PEG
(n = 3312)
|
Modern MBG
(n = 457)
|
P–value
|
Age (years)
|
Number of cases/articles
|
3062/24
|
367/8
|
NA
|
Mean
|
66.4 (21–93)
|
66.5 (31–88)
|
Follow–up duration (months)
|
Number of cases/articles
|
3312/25
|
457/10
|
NA
|
Mean
|
73.1 (12–211)
|
56.1
|
Gain of FE (°)
|
Number of cases/articles
|
1387/14
|
142/2
|
NA
|
Mean
|
48.6
|
61.7
|
Gain of ER (°)
|
Number of cases/articles
|
1304/14
|
161/3
|
NA
|
Mean
|
24.2
|
39.2
|
Constant score improvement
|
Number of cases/articles
|
1208/9
|
3/97
|
NA
|
Mean
|
34.8
|
40.4
|
ASES score improvement
|
Number of cases/articles
|
226/5
|
135/3
|
NA
|
Mean
|
44.5
|
56.5
|
Primary osteoarthritis
|
Yes (%)
|
2866 (86.5%)
|
350 (88.4%)
|
0.310
|
No (%)
|
446 (13.5%)
|
46 (11.6%)
|
Diagnosis unknown
|
1
|
61
|
Radiolucent lines
|
Present (%)
|
354 (27.2%)
|
22 (4.9%)
|
NA
|
Absent (%)
|
948 (72.8%)
|
427 (95.1%)
|
Not reported
|
2010
|
8
|
Loosening
|
Present (%)
|
465 (14.6%)
|
22 (4.9%)
|
NA
|
Absent (%)
|
2720 (85.4%)
|
427 (95.1%)
|
Not reported
|
127
|
8
|
Revision surgery
|
Present (%)
|
189 (5.7%)
|
11 (2.4%)
|
NA
|
Absent (%)
|
3127 (94.3%)
|
446 (97.6%)
|
Not reported
|
0
|
0
|
PEG, all-polyethylene glenoid; MBG, metal-backed glenoid; NA, not applicable; FE, forward elevation; ER, external rotation; ASES, American shoulder and elbow surgeons,
Table 4. Subgroup analysis according to the follow-up duration
Items
|
<36-month subgroupa
|
36–72-month subgroupb
|
>72-month subgroupc
|
|
PEG
|
MBG
|
PEG
|
MBG
|
PEG
|
MBG
|
Age (years)
|
66.7
|
64.8
|
66.9
|
67.3
|
65.3
|
62.7
|
Number of radiolucency (%)
|
38/439 (7.3%)
|
8/65
(12.3%)
|
20/229
(8.7%)
|
31/182
(17.0%)
|
296/709 (41.7%)
|
8/35
(22.9%)
|
|
P = 0.355
|
P = 0.015 *
|
P = 0.033 *
|
Number of loosening
|
2/420
(0.5%)
|
5/65
(7.7%)
|
19/1459
(1.3%)
|
17/269
(6.3%)
|
443/1306
(33.9%)
|
0/115
(0%)
|
|
P < 0.001 *
|
P < 0.001 *
|
P < 0.001 *
|
Number of failure (=revision)
|
19/424 (4.5%)
|
4/65
(6.2%)
|
37/1503 (2.5%)
|
5/277
(1.8%)
|
133/1389
(9.6%)
|
2/115
(1.7%)
|
|
P = 0.754
|
P = 0.829
|
P = 0.002 *
|
FU, follow-up; PEG, cemented all-polyethylene glenoid; MBG, metal-backed glenoid
a follow-up duration less than 36 months
b follow-up duration between 36 and 72 months
c follow-up duration more than 72 months
*statistically significant change
Table 5. Subgroup analysis except for 3 articles which included only young adults
Items
|
<36-month subgroupa
|
36–72-month subgroupb
|
>72-month subgroupc
|
|
PEG
|
MBG
|
PEG
|
MBG
|
PEG
|
MBG
|
Age (years)
|
66.7
|
64.8
|
66.9
|
67.3
|
66.7
|
62.7
|
Number of radiolucency (%)
|
38/439 (7.3%)
|
8/65
(12.3%)
|
20/229
(8.7%)
|
31/182
(17.0%)
|
256/640 (40.0%)
|
8/35
(22.9%)
|
|
P = 0.355
|
P = 0.015 *
|
P = 0.05
|
Number of loosening
|
2/420
(0.5%)
|
5/65
(7.7%)
|
19/1459
(1.3%)
|
17/269
(6.3%)
|
402/1191
(33.8%)
|
0/115
(0%)
|
|
P < 0.001 *
|
P < 0.001 *
|
P < 0.001 *
|
Number of failure (=revision)
|
19/424 (4.5%)
|
4/65
(6.2%)
|
37/1503 (2.5%)
|
5/277
(1.8%)
|
106/1272
(8.3%)
|
2/115
(1.7%)
|
|
P = 0.754
|
P = 0.829
|
P = 0.006 *
|
FU, follow-up; PEG, cemented all-polyethylene glenoid; MBG, metal-backed glenoid
a follow-up duration less than 36 months
b follow-up duration between 36 and 72 months
c follow-up duration more than 72 months
*statistically significant change