Risks of loosening of a prosthetic glenoid implanted in retroversion

Farron, Alain; Terrier, Alexandre; Büchler, Philippe

doi:10.1016/j.jse.2005.10.003

Cited by 347 publications

(181 citation statements)

References 22 publications

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“…In a review of nearly 3000 total shoulder arthroplasties, Bohsali et al [5] reported the incidence of aseptic loosening to be 39% after 5 years, with 83% of cases attributed to failure of the glenoid component. Shoulder arthroplasty in the setting of posterior glenoid bone loss is associated with a threefold increase in stress in the cement mantle and sevenfold increase in glenoid component micromotion [13,14,37]. Glenoid component retroversion decreases glenohumeral contact area, increases contact pressure, and may lead to eccentric loading with resultant glenoid component loosening [14,37].…”

Section: Introductionmentioning

confidence: 99%

Posterior Glenoid Wear in Total Shoulder Arthroplasty: Eccentric Anterior Reaming Is Superior to Posterior Augment

Wang

Abrams

Behn

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Uncorrected glenoid retroversion during total shoulder arthroplasty may lead to an increased likelihood of glenoid prosthetic loosening. Augmented glenoid components seek to correct retroversion to address posterior glenoid bone loss, but few biomechanical studies have evaluated their performance. Questions/purposes We compared the use of augmented glenoid components with eccentric reaming with standard glenoid components in a posterior glenoid wear model. The primary outcome for biomechanical stability in this model was assessed by (1) implant edge displacement in superior and inferior edge loading at intervals up to 100,000 cycles, with secondary outcomes including (2) implant edge load during superior and inferior translation at intervals up to 100,000 cycles, and (3) incidence of glenoid fracture during implant preparation and after cyclic loading. Methods A 12°-posterior glenoid defect was created in 12 composite scapulae, and the specimens were divided in two equal groups. In the posterior augment group, glenoid version was corrected to 8°and an 8°-augmented polyethylene glenoid component was placed. In the eccentric reaming group, anterior glenoid reaming was performed to neutral version and a standard polyethylene glenoid component was placed. Specimens were cyclically loaded in the superoinferior direction to 100,000 cycles. Superior and inferior glenoid edge displacements were recorded. Results Surviving specimens in the posterior augment group showed greater displacement than the eccentric reaming group of superior (1.01 ± 0.02 [95% CI, 0.89-1.13] versus 0. 83 ± 0.10 [95% CI,

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Section: Introductionmentioning

confidence: 99%

Posterior Glenoid Wear in Total Shoulder Arthroplasty: Eccentric Anterior Reaming Is Superior to Posterior Augment

Wang

Abrams

Behn

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Undercorrection of retroversion can result in persistent posterior humeral head subluxation, which causes eccentric loading of the glenoid component and premature loosening [11][12][13]. Biomechanical studies suggest that this risk can be minimized by placing the glenoid component in less than 10°of retroversion [11].…”

Section: Defined This Translation In Twomentioning

confidence: 99%

“…Biomechanical studies suggest that this risk can be minimized by placing the glenoid component in less than 10°of retroversion [11].…”

Section: Defined This Translation In Twomentioning

confidence: 99%

Surgical management of the biconcave (B2) glenoid

Donohue

Ricchetti

Iannotti

2016

Curr Rev Musculoskelet Med

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Glenohumeral osteoarthritis produces a wide spectrum of glenoid pathology. The B2 glenoid is defined by asymmetric posterior bone loss with the development of a biconcavity and posterior translation of the humeral head. Progressive bone loss results in increasing glenoid retroversion, which must be corrected during anatomic shoulder arthroplasty. The goals of arthroplasty should also include centering the humeral head and restoring the normal glenoid joint line. When there is minimal bone loss, this may be accomplished with a standard glenoid component and asymmetric reaming. More significant bone loss requires bone grafting or the use of an augmented glenoid component. Reverse shoulder arthroplasty is also an option for older patients or patients with severe bone loss.

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“…Most surgeons will attempt to reduce glenoid retroversion to 10°to 15°as clinical and biomechanical data support increased risk for glenoid component loosening if the glenoid is placed in higher degrees of retroversion [8, 9•, 10]. Farron et al performed a study utilizing finite element modeling and determined that micro-motion at the bone-cement interface was strongly influenced by retroversion [8]. They determined that there was an exponential increase in maximal (+706 %) and mean (+669 %) micro-motion for internal and external rotation when the glenoid component was placed in greater than 10°o f retroversion [8].…”

Section: Introductionmentioning

confidence: 99%

“…Farron et al performed a study utilizing finite element modeling and determined that micro-motion at the bone-cement interface was strongly influenced by retroversion [8]. They determined that there was an exponential increase in maximal (+706 %) and mean (+669 %) micro-motion for internal and external rotation when the glenoid component was placed in greater than 10°o f retroversion [8]. Shapiro et al performed a biomechanical study with a custom cadaveric shoulder testing system and determined that placement of a glenoid component in 15°of…”

Section: Introductionmentioning

confidence: 99%

Planning software and patient-specific instruments in shoulder arthroplasty

Wylie

Tashjian

2016

Curr Rev Musculoskelet Med

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Computer planning software and patient-specific instrumentation have been investigated in multiple subspecialties of orthopedics with mixed results. Shoulder arthroplasty has evolved over the last decade with improvements in implant design and surgical instrumentation. Despite these advances, glenoid positioning in shoulder arthroplasty continues to be a difficult problem. Recent advances in threedimensional imaging techniques and the use of computer planning software may potentially address some of the common difficulties encountered by surgeons. The addition of patient-specific instrumentation and guides provide an option for patients with significant glenoid deformity that may allow improved accuracy of glenoid component implantation compared to using standard instrumentation. Studies have reported improved positioning of the glenoid component in both anatomic and reverse total shoulder arthroplasty with patientspecific instrumentation and guides. More research is needed to determine whether these improvements lead to better patient-reported outcomes or implant survival. In addition, further studies will be needed to address whether this technology is cost effective for large-scale implementation in the orthopedic community.

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Risks of loosening of a prosthetic glenoid implanted in retroversion

Cited by 347 publications

References 22 publications

Posterior Glenoid Wear in Total Shoulder Arthroplasty: Eccentric Anterior Reaming Is Superior to Posterior Augment

Posterior Glenoid Wear in Total Shoulder Arthroplasty: Eccentric Anterior Reaming Is Superior to Posterior Augment

Surgical management of the biconcave (B2) glenoid

Planning software and patient-specific instruments in shoulder arthroplasty

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