• INTRODUCTION
    • This study aimed to compare outcomes between glenoid components in shoulder replacement surgery. Our focus was on clinical and radiographic outcomes in a matched cohort study with long-term follow-up.
  • METHODS
    • This study included anatomic TSA cases performed by one fellowship-trained shoulder and elbow surgeon at one institution between 2001 and 2015. The choice of glenoid implant type was made intraoperatively. All glenoids were cemented. A cardinal matching algorithm using the Matchit package in R was employed to create a 1:2 cohort of patients receiving polyethylene keeled and pegged glenoid designs. The cohort groups were matched for age, sex, pre-op ASES score, and Walch classification. Shoulder ROM and PROs were measured throughout the study. Glenoid loosening was assessed radiographically using the Lazarus scoring system.
  • RESULTS
    • The study analyzed 36 TSAs, comprising 12 keeled glenoid components and 24 pegged components. The average follow-up was 8.9 years (range 5.0-13.4) in the keeled glenoid group and 9.2 (range 3.5-17.3) years in the pegged glenoid groups, respectively. Demographic characteristics were not significantly different. Both keeled and pegged glenoid groups showed significant improvements in all ROM and PRO measurements postoperatively. When directly compared, there were no significant differences in postoperative ROM: forward elevation (p=0.333), external rotation (p=0.462), or internal rotation (p=0.411). Similarly, no significant differences were found in postoperative PRO scores: ASES (p=0.192), SST (p=0.662), or VAS (p=0.101). A Lazarus score of 0 was the most glenoid loosening score in both cohorts, although this was not statistically significant (66.7% vs. 83.3%; p=0.479). None of the other glenoid loosening scores showed significant differences between groups. Among the 36 TSAs, one keeled glenoid (8.3%) was revised after 9.95 years due to glenoid loosening.
  • DISCUSSION AND CONCLUSION
    • Both glenoid configurations led to sustained postoperative improvements in ROM and PROs, and there was no meaningful variation in radiographic stability when pegged and keeled glenoids were compared.