Radiographic comparison of pegged and keeled glenoid components using modern cementing techniques: A prospective randomized study

Background: Modern cementing techniques have improved glenoid fixation, reduced glenoid lucency seen with keeled components, and may eliminate differences attributable to glenoid design. The purpose of this study was to determine the effect of glenoid design on immediate and follow-up radiographic lucency of pegged and keeled glenoid components, using modern cementing techniques. Material and methods: Fifty-three total shoulder arthroplasties were performed in patients with primary glenohumeral osteoarthritis. Patients were randomized prospectively to receive either a pegged or keeled glenoid component. Three raters graded radiographic glenoid lucencies. Results: On immediate radiographs, there was no significant difference in the rate of glenoid lucency between pegged (0%) and keeled (15%) glenoid components (P = .128). However, after an average of 26 months, the rate of glenoid lucency was significantly higher in patients with keeled components (46%) compared to patients with pegged components (15%) (P = .003). Conclusion: Even with modern cementing techniques, pegged glenoid components remain radiographically superior to keeled glenoid components. Level of evidence: Level I, Randomized Clinical Trial, Treatment study. (C) 2010 Journal of Shoulder and Elbow Surgery Board of Trustees.