Cemented all-polyethylene versus hybrid glenoid components in conventional total shoulder arthroplasty for osteoarthritis: a retrospective cohort study using data from the Dutch Arthroplasty Registry

Approval date: January 2025
Starting date: February 7th 2025

TDW Alta, MPJ van den Bekerom, S van der Breggen, M Karel, AA Macken, AA Masjediy

Research proposal abstract:
Anatomic total shoulder arthroplasty (ATSA) is used as a treatment for glenohumeral
osteoarthritis, aiming to provide pain relief and improve shoulder function, with overall
favourable results. However, glenoid loosening remains the most common cause of implant
failure and revision surgery. Therefore, a key factor in the success of ATSA is the type of
glenoid component used. Cemented all-polyethylene glenoid components have been
widely regarded the gold standard due to their long-term performance. Over the past
decade, hybrid glenoid components were developed aiming to improve the long-term
component survival, combining a highly porous metal peg or cage with a polyethylene
surface, designed to improve fixation and reduce loosening rates.

While early studies show promising results for hybrid components in the short- to midterm,
large-scale data comparing their performance to cemented all-polyethylene
components are lacking. Previous studies include relatively small cohorts, while implant
loosening requiring a revision is rare. To date, there is inconclusive evidence on whether
hybrid glenoid components provide superior long-term outcomes in terms of revision rates
and implant survival, with current studies reporting conflicting results. Additionally, there is
limited evidence on how variations in surgical technique, specifically the use of cemented
versus uncemented fixation of the polyethylene surface in hybrid components, influences
these outcomes.

For these reasons, the aim of this study is to compare the revision rates in ATSA between
cemented all-polyethylene and hybrid glenoid components (both cemented and
uncemented) using data from the Dutch Arthroplasty Registry (LROI). Additionally, this
study will evaluate the impact of using cemented versus uncemented fixation for the
polyethylene component in hybrid glenoid designs on implant outcomes.