Glenoid Failure after Total Shoulder Arthroplasty, cemented all-polyethylene versus metal-backed: A Systematic Review Protocol

Abstract BackgroundAnatomical Total Shoulder Arthroplasty (TSA) is an effective treatment adopted in patients with glenohumeral osteoarthritis. The glenoid component failure is the main risk that occurs in this therapeutic choice; however, doubts remain, regarding the selection of the best implant in order to avoid such complication.MethodsA systematic review of randomized clinical trials (RCTs) or quasi will be carried out, applying the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocols, comparing polyethylene (keeled and pegged) versus metal back implants in adult patients with glenohumeral osteoarthritis.Our search strategy will be carried out in the MEDLINE, PubMed, Cochrane Central Register of Controlled Trials, EMBASE, Web of Science. Data management and extraction will be performed using a data withdrawal form and by analyzing study method characteristics, participant characteristics, intervention characteristics, results, methodological domains. The summaries of research evidence will be accessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Shoulder function through functional scores such as Constant-Murley (CM) and American Shoulder and Elbow Surgeons (ASES), pain (Visual Analogue Scale), infection, procedure failure, radiograph radiolucency and loosening, are the selected outcomes. Another analysis such as subgroup, heterogeneity, sensitivity and statistical are going to be performed whenever possible.DiscussionThis systematic review aims to analyze how glenoidal implants behave in Total Shoulder Arthroplasties and therefore provide evidence concerning the best clinical practice to avoid complication. Systematic review registrationPROSPERO, CRD 42018079537.