Contact stresses in the glenoid component in total shoulder arthroplasty

2003 ◽  
Vol 217 (1) ◽  
pp. 49-57 ◽  
Author(s):  
W Swieszkowski ◽  
P Bednarz ◽  
P J Prendergast
Keyword(s):  
Shoulder Arthroplasty ◽  
Polyethylene Wear ◽  
Total Shoulder Arthroplasty ◽  
Peak Stress ◽  
Contact Stresses ◽  
High Rate ◽  
Glenoid Component ◽  
Wear Properties ◽  
Cold Flow

Several studies of retrieved glenoid components from total shoulder arthroplasty show an erosion of the rim, surface irregularities, component fracture and wear resulting from polyethylene deformation in vivo. Particles resulting from polyethylene wear might be one of the reasons for the very high rate of glenoid component loosening found clinically. Because wear can be the result of high contact stresses, the aim of this study is to find out whether or not contact stresses are high enough to cause wear of the glenoid component and what influence the component type and geometry have on polyethylene contact stresses for different humerus abduction angles. Elasticity theory is used in a parametric study of contact stresses in several glenoid component designs. A finite element method is used to confirm the accuracy of the analytical solution. The analysis shows that the peak stress generated in glenoid components under conditions of normal living can be as high as 25 MPa; since this exceeds the polyethylene yield strength, wear and also cold flow of the components can be expected. It is predicted that more conforming components have lower contact stresses, which might result in lower wear rate and less cold flow. It is also found that a metal-backed component promotes higher contact stresses than an all-polyethylene component with the same total thickness, therefore it can be expected that metal-backed components have inferior wear properties.

scholarly journals Anatomical total shoulder arthroplasty in young patients with osteoarthritis

2018 ◽  
Vol 100-B (4) ◽  
pp. 485-492 ◽  
Author(s):  
M. O. Gauci ◽  
N. Bonnevialle ◽  
G. Moineau ◽  
M. Baba ◽  
G. Walch ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Polyethylene Wear ◽  
Total Shoulder Arthroplasty ◽  
Young Patients ◽  
Glenoid Component ◽  
Implant Survival ◽  
Survivorship Analysis ◽  
Kaplan Meier ◽  
Glenoid Loosening

Aims Controversy about the use of an anatomical total shoulder arthroplasty (aTSA) in young arthritic patients relates to which is the ideal form of fixation for the glenoid component: cemented or cementless. This study aimed to evaluate implant survival of aTSA when used in patients aged < 60 years with primary glenohumeral osteoarthritis (OA), and to compare the survival of cemented all-polyethylene and cementless metal-backed glenoid components. Materials and Methods A total of 69 consecutive aTSAs were performed in 67 patients aged < 60 years with primary glenohumeral OA. Their mean age at the time of surgery was 54 years (35 to 60). Of these aTSAs, 46 were undertaken using a cemented polyethylene component and 23 were undertaken using a cementless metal-backed component. The age, gender, preoperative function, mobility, premorbid glenoid erosion, and length of follow-up were comparable in the two groups. The patients were reviewed clinically and radiographically at a mean of 10.3 years (5 to 12, sd 26) postoperatively. Kaplan–Meier survivorship analysis was performed with revision as the endpoint. Results A total of 26 shoulders (38%) underwent revision surgery: ten (22%) in the polyethylene group and 16 (70%) in the metal-backed group (p < 0.0001). At 12 years’ follow-up, the rate of implant survival was 74% (sd 0.09) for polyethylene components and 24% (sd 0.10) for metal-backed components (p < 0.0002). Glenoid loosening or failure was the indication for revision in the polyethylene group, whereas polyethylene wear with metal-on-metal contact, instability, and insufficiency of the rotator cuff were the indications for revision in the metal-backed group. Preoperative posterior subluxation of the humeral head with a biconcave/retroverted glenoid (Walch B2) had an adverse effect on the survival of a metal-backed component. Conclusion The survival of a cemented polyethylene glenoid component is three times higher than that of a cementless metal-backed glenoid component ten years after aTSA in patients aged < 60 years with primary glenohumeral OA. Patients with a biconcave (B2) glenoid have the highest risk of failure. Cite this article: Bone Joint J 2018;100-B:485–92.

In vivo wear of polyethylene glenoid components in total shoulder arthroplasty

e-Polymers ◽  
2005 ◽  
Vol 5 (1) ◽  
Author(s):  
Wojciech Swieszkowski ◽  
Mark Frankle ◽  
Harald E. N. Bersee ◽  
Krzysztof J. Kurzydlowski
Keyword(s):  
Wear Rate ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Laser Scanner ◽  
Sem Analysis ◽  
Glenoid Component ◽  
Wear Depth ◽  
Volumetric Wear ◽  
Revision Operation

AbstractLoosening of the glenoid component after a total shoulder arthroplasty, leading to pain and the need for a revision operation, accounts for one third of all shoulder replacement complications. It has been shown that glenoid loosening could be a result of osteolysis of periprosthetic bone induced by polymeric wear debris. The aim of this study was to determine the amount and pattern of in vivo wear of polyethylene glenoid components by examining a set of so-called retrievals. Six glenoid components were retrieved and examined (5 all-polyethylene and 1 metal-backed). The average time of functioning of these components in human bodies was 10 years with the shortest time of 7 and longest 14 years. Four components were scanned using a laser scanner. The results of measurements have been used to generate geometrical models of the retrievals using CAD software. These models have been subsequently used to determine the maximum depth and volumetric wear rate for each component. All six retrievals were examined using scanning electron microscopy (SEM). The maximum volumetric wear rate and wear depth for the analyzed retrievals was 30 mm3/year and 0.2 mm/year, respectively. From SEM analysis of the retrievals it was found that at macroscopic level the worn surfaces consist of (a) polished and (b) scratched regions. Intensive wear areas and fine multidirectional scratches were dominant in all retrievals. Random scratches were also observed, most probably due to third body wear (cement particles). In two implants pitting areas and surface micro-cracks have been observed, which most likely result from subsurface fatigue.

Failure of the Glenoid Component in Anatomic Total Shoulder Arthroplasty

2013 ◽  
Vol 95 (24) ◽  
pp. 2205-2212 ◽  
Author(s):  
Anastasios Papadonikolakis ◽  
Moni Blazej Neradilek ◽  
Frederick A Matsen
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Glenoid Component

scholarly journals Journey of the glenoid in anatomic total shoulder replacement

2018 ◽  
Vol 11 (2) ◽  
pp. 140-148 ◽  
Author(s):  
Alessandro Castagna ◽  
Raffaele Garofalo
Keyword(s):  
Shoulder Arthroplasty ◽  
Current Practice ◽  
Total Shoulder Arthroplasty ◽  
Shoulder Function ◽  
Patient Specific ◽  
Glenoid Component ◽  
Shoulder Replacement ◽  
Final Destination ◽  
Component Loosening

Anatomic total shoulder arthroplasty (TSR) has been shown to generate good to excellent results for patients with osteoarthritis and a functioning rotator cuff. Many studies have reported that the glenoid component loosening and failure remain the most common long-term complication of total shoulder arthroplasty. The approach to glenoid component is critical because a surgeon should consider patient-specific anatomy, preserving bone stock and joint line restoration, for a good and durable shoulder function. Over the years, different glenoid design and materials have been tried in various configurations. These include cemented polyethylene, uncemented metal-backed and hybrid implants. Although advances in biomechanics, design and tribology have improved our understanding of the glenoid, the journey of the glenoid component in anatomic total shoulder arthroplasty has not yet reached its final destination. This article attempts to describe the evolution of the glenoid component in anatomic TSR and current practice.

In vivo blood metal ion levels in patients after total shoulder arthroplasty

2019 ◽  
Vol 28 (3) ◽  
pp. 539-546 ◽  
Author(s):  
Tobias Reiner ◽  
Nina Bader ◽  
Benjamin Panzram ◽  
Matthias Bülhoff ◽  
Georg Omlor ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Metal Ion ◽  
Total Shoulder Arthroplasty

Use of a custom alignment guide to improve glenoid component position in total shoulder arthroplasty

2012 ◽  
Vol 21 (12) ◽  
pp. 2860-2866 ◽  
Author(s):  
Eduardo M. Suero ◽  
Musa Citak ◽  
Darrick Lo ◽  
Aaron J. Krych ◽  
Edward V. Craig ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Glenoid Component ◽  
Component Position ◽  
Alignment Guide
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