Glenoid perforation does not affect the short-term outcomes of pegged all-polyethylene implants in total shoulder arthroplasty

Background: The glenoid vault can be perforated during pegged glenoid preparation in total shoulder arthroplasty. The clinical implications of glenoid vault perforation, however, are unknown. The purpose of this study was to determine the effects of perforation of the glenoid during total shoulder arthroplasty on clinical and radiographic outcomes. Materials and methods: Eighteen patients with known intraoperative glenoid perforations were prospectively identified and compared with 34 patients matched by age, gender, diagnosis, and arm dominance during the same period. Patients were evaluated with multiple outcome scores. Radiographs were evaluated for glenoid lucency immediately postoperatively and at final follow-up. Results: Average follow-up was 28.1 months for the perforated group and 31.2 months for the matched controls. Both groups had significant improvements in outcome scores postoperatively. American Shoulder and Elbow Surgeons scores increased from 39.8 to 91.0 (P < .001) in the perforated group and from 36.9 to 82.6 (P < .001) in the control group. Constant scores increased from 24.4 to 77.4 (P < .001) in the perforated group and from 36.9 to 75.6 (P < .001) in the control group. Ninety-four percent of the perforated group and 80% of the matched controls were satisfied or very satisfied with their result (P=.896). The presence and number of perforations were not related to the American Shoulder and Elbow Surgeons score (P=.549), Constant score (P=.154), or radiographic lucency grade (P=.584). Conclusions: Glenoid perforation during pegged glenoid preparation in total shoulder arthroplasty does not seem to have an adverse effect on clinical or radiographic outcomes at an average of 2 years of follow-up. Level of evidence: Level III, Case Control Design, Treatment Study. (C) 2014 Journal of Shoulder and Elbow Surgery Board of Trustees.