The subchondral bone layer and glenoid implant design are relevant for primary stability in glenoid arthroplasty

Background: Clinical studies suggest that reaming of the subchondral bone layer to achieve good implant seating is a risk factor for glenoid loosening. This study aims to evaluate (1) the importance of the subchondral bone layer and (2) the influence of the design of the glenoid component. - METHODS...

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Hauptverfasser: Sowa, Boris (VerfasserIn) , Bochenek, Martin (VerfasserIn) , Braun, Steffen (VerfasserIn) , Kretzer, Jan Philippe (VerfasserIn) , Zeifang, Felix (VerfasserIn) , Bruckner, Thomas (VerfasserIn) , Walch, Gilles (VerfasserIn) , Raiss, Patric (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 04 July 2018
In: Archives of orthopaedic and trauma surgery
Year: 2018, Jahrgang: 138, Heft: 11, Pages: 1487-1494
ISSN:1434-3916
Online-Zugang: Volltext
Verfasserangaben:Boris Sowa, Martin Bochenek, Steffen Braun, Jan Philippe Kretzer, Felix Zeifang, Thomas Bruckner, Gilles Walch & Patric Raiss

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520 |a Background: Clinical studies suggest that reaming of the subchondral bone layer to achieve good implant seating is a risk factor for glenoid loosening. This study aims to evaluate (1) the importance of the subchondral bone layer and (2) the influence of the design of the glenoid component. - METHODS: Different techniques for preparation of an A1 glenoid were compared: (1) preserving the subchondral bone layer; (2) removal of the subchondral bone layer; (3) implantation of a glenoid component that does not adapt to the native anatomy. Artificial glenoid bones (n = 5 each) were used with a highly standardized preparation and implantation protocol. Biomechanical testing was performed during simulated physiological shoulder motion. Using a high-resolution optical system, the micromotions between implant and bone were measured up to 10,000 motion cycles. - RESULTS: At the 10,000 cycle measuring point, significantly more micromotions were found in the subchondral layer removed group than in the subchondral layer preserved group (p = 0.0427). The number of micromotions in the nonadapted group was significantly higher than in the subchondral layer preserved group (p = 0.0003) or the subchondral layer removed group (p = 0.0207). - CONCLUSION: Conservative reaming proved important to diminish the micromotions of the glenoid component. Implantation of a glenoid component that matches with the bony underlying glenoid can help to preserve the subchondral bone layer without sacrificing proper implant seating. 
650 4 |a A1 
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650 4 |a Arthroplasty, Replacement, Shoulder 
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650 4 |a Models, Anatomic 
650 4 |a Prosthesis Design 
650 4 |a Reaming 
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