Bone cement penetration pattern and primary stability testing in keeled and pegged glenoid components

Background - It has been proposed that bone mineral density has an influence on cement penetration in hip and knee arthroplasty. The hypotheses of this study were that: 1) there is a negative correlation between bone mineral density (BMD) and cement penetration in cemented glenoid components; and 2)...

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Main Authors: Raiss, Patric (Author) , Pape, Guido (Author) , Kleinschmidt, Kerstin (Author) , Jäger, Sebastian (Author) , Sowa, Boris (Author) , Jakubowitz, Eike (Author) , Loew, Markus (Author) , Bruckner, Thomas (Author) , Rickert, Markus (Author)
Format: Article (Journal)
Language:English
Published: 2011
In: Journal of shoulder and elbow surgery
Year: 2011, Volume: 20, Issue: 5, Pages: 723-731
ISSN:1532-6500
DOI:10.1016/j.jse.2010.09.006
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jse.2010.09.006
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S1058274610004064
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Author Notes:Patric Raiss, Guido Pape, Kerstin Kleinschmidt, Sebastian Jäger, Boris Sowa, Eike Jakubowitz, Markus Loew, Thomas Bruckner, Markus Rickert
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Summary:Background - It has been proposed that bone mineral density has an influence on cement penetration in hip and knee arthroplasty. The hypotheses of this study were that: 1) there is a negative correlation between bone mineral density (BMD) and cement penetration in cemented glenoid components; and 2) that implant design has an influence on cement penetration into the glenoid bone. - Methods - BMD of 10 pairs of fresh frozen scapulas was measured. Micro-computed tomography (micro-CT) scans in 3 different sections were analyzed after implantation of keeled and pegged glenoid components using a 3rd-generation cementing technique with a vacuum mixing system. Cement penetration was analyzed and correlated with BMD. Pull-out strength testing was performed to analyze primary stability. - Results - The overall peak BMD was 0.6 [g/cm2] (range, 0.33-0.98). A strong negative correlation between BMD and mean cement penetration was found for the peg (R2 = −.83; P < .003) and for the keel group (R2 = −.81; P < .005). Mean cement penetration was 78.4 mm2 (range, 60.6-94.2) in the keel and 113.9 mm2 (range, 78.2-143.4) in the peg group (P < .0001). In all cases, the components were pulled out of the cement mantle, whereas the bone-cement interfaces remained intact. The mean pull-out strength was 1093N (764-1343N) for keeled and 884N (650-1264N) for pegged components (P < .05). - Conclusion - A modern cementing technique, leading to a deep bonding between bone and cement, is crucial to prevent loosening of glenoid components. The findings of this study might help us to better understand the results of follow-up studies of cemented glenoid implants. Our results could be helpful for the choice of implants in patients with poor bone quality like osteoporosis or rheumatoid arthritis.
Item Description:Available online 30 December 2010
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Physical Description:Online Resource
ISSN:1532-6500
DOI:10.1016/j.jse.2010.09.006