Thursday, February 23, 2012

Glenoid component fixation. Vacuum assist glenoid fixation: does this technique lead to a more durable glenoid component? JSES

JSES October 2011 published an article Vacuum assist glenoid fixation: does this technique lead to a more durable glenoid component? in which suction is applied to the glenoid vault as a means of removing fluid trapped within the glenoid vault and increasing the amount of cement in the glenoid bone for fixation of a glenoid component. They found that using a special device (that is no longer available) to apply suction to the bone the amount of cement in the glenoid was increased and the number of radiolucent zones were diminished. Of note, however, is the observation that even with this method, the authors had 33% radiolucent lines on postoperative x-rays using the Bigliani-Flatow system.

As we have pointed out in a previous post, more cement can generate more heat in the glenoid bone, risking the possibility of thermal damage to the bone, so more cement may not be the goal.

We use a different approach to the removal of fluid from the prepared glenoid bone, employing a carbondioxide spray just before the cement is pressurized.
The consistent result is the absence of radiolucent lines with a minimal amount of cement as shown in the radiograph below.


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