SynthesisInternational orthopaedics2026
Long-term glenoid loosening, radiological and clinical outcomes in cemented all-polyethylene anatomic total shoulder arthroplasty: a systematic review and meta-analysis.
Synthesis in International orthopaedics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
backgroundAnatomic total shoulder arthroplasty (aTSA) is commonly recommended for osteoarthritis, but its long-term durability remains a concern, particularly in younger, active patients. This systematic review evaluates the clinical and radiological outcomes of all-polyethylene (all-PE) glenoid components at a minimum ten year follow-up.
methodsConducted according to PRISMA guidelines, 15 studies involving 1163 procedures were identified. Inclusion required a mean follow-up exceeding nine years and the availability of radiographic analysis. Outcomes included rates of glenoid loosening, rotator cuff deficiency, clinical satisfaction, and implant survival.
resultsAt a mean 11.8 year follow-up, radiographic glenoid loosening occurred in 41.0%; (95% CI: 30.0%-52.0%) of cases. Signs of cuff deficiency were observed in 210/599 cases (44.0%; 95% CI: 33.0%-55.0%). The overall revision rate was 17.0% (95%CI: 12.0%-23.0%), while the rate of objectively unsatisfactory clinical results was 31.0% (95%CI: 23.0%-40.0%). Survival rates were 93.0% (95%CI: 91.3-94.7%) at 10 years, 85.1% (95%CI: 81.5-88.7%) at 15 years and 82.5% (95%CI: 77.3-87.8%) at 20 years. Pooled proportions with 95% confidence intervals were estimated using random-effects meta-analysis.
conclusionLong-term aTSA is associated with high rates of radiographic failure and soft-tissue insufficiency. A notable discrepancy exists between radiographic failure (41.0%) and lower revision rates (17.0%), suggesting that revision rates might under estimate actual failure. Thorough counseling regarding these cumulative failure risks is recommended for younger patients.
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