Friday, November 30, 2012

Ingrowth glenoid component

Fixation and durability of a bone-ingrowth component for glenoid bone loss JSES

This article report the use of a metal backed glenoid in the management of glenohumeral arthritis in the face of central or peripheral glenoid bone deficiencies from either arthritic wear or failure of prior arthroplasty. The authors point out to the common deficiency of posterior glenoid bone in shoulder arthroplasty and the challenges associated with reconstruction in this context. While many authors are fixated on the 'need for normalizing glenoid version' there is another view as pointed out in a recent post. Recent enthusiasm for the use of step or asymmetrical glenoid components to achieve stability does not seem to be supported by the clinical results.

This article presents an attempt to achieve a robust glenoid arthroplasty using a a metal backed glenoid. By 11 years after surgery 7 of the 21 arthroplasties required revision. Among the unrevised shoulders  4 were at risk for glenoid loosening, and 1 was at risk for humeral loosening.  Common problems included accelerated polyethylene wear, metal wear, bone osteolysis, and a high frequency of clinical glenoid component loosening.

These results with a metal backed glenoid component are consistent with previous reports and this prior report by the same senior authors.


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