Comparison of Pegged and Keeled Glenoid Components for Total Shoulder Arthroplasty

Background Limited evidence exists regarding the relative rates of glenoid loosening after total shoulder arthroplasty utilizing pegged or keeled cemented all-polyethylene glenoid components. Methods A systematic review of level I, II, and III studies comparing the development of radiolucent lines and glenoid failure after total shoulder arthroplasty with pegged or keeled glenoid components was conducted. Four articles were included in the final analysis with a total of 203 total shoulder arthroplasties comprising 107 pegged and 96 keeled glenoid components. Results Development of radiolucent lines was less likely with pegged glenoid components with a risk difference of −0.32 (95% CI −0.62, −0.03) favoring the pegged design. There was no statistically significant difference in the rate of radiographically at-risk glenoids, clinical glenoid failure, or the composite endpoint. Conclusions Although the development of radiolucent lines was less likely around pegged glenoid components, there was no significant difference in the rate of radiographic or clinical glenoid failure between pegged and keeled components. More high-quality studies are needed to determine the relative rates of glenoid loosening with pegged and keeled glenoid components.