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.

scholarly journals Wear performance of inverted non-conforming bearings in anatomic total shoulder arthroplasty

2019 ◽  
Vol 12 (1_suppl) ◽  
pp. 40-52
Author(s):  
Lorenzo Banci ◽  
Alessio Meoli ◽  
Martin Hintner ◽  
Hans Rudolf Bloch
Keyword(s):  
Vitamin E ◽  
Wear Rate ◽  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Total Shoulder Arthroplasty ◽  
Niobium Nitride ◽  
Shoulder Prosthesis ◽  
Glenoid Component ◽  
Uhmwpe Wear

Background Glenoid component failures still represent the most common complication in total shoulder arthroplasty. These failures depend on several factors, including ultra-high molecular weight polyethylene (UHMWPE) wear. One reason for UHMWPE wear in total shoulder arthroplasty may be the current use of a spherical prosthetic humeral head against a radially mismatched UHMWPE glenoid component, which leads to reduced glenohumeral translations, glenoid edge loading and high translational forces during shoulder motions. The aim of this study was to assess the in vitro wear of an anatomic total shoulder prosthesis with non-spherical non-conforming bearings with inverted conventional materials. Methods The wear of a vitamin E-blended UHMWPE non-spherical humeral head articulating against a non-conforming titanium-niobium nitride (TiNbN)-coated metallic glenoid was tested using a joint simulator. The wear test was performed by applying a constant load of 756 N with angular motions and translations. Results After 2.5 million cycles, the mean wear rate of the humeral head was 0.28 ± standard deviation (SD) 0.45 mg/million cycles. Conclusion The low wear rate of the vitamin E UHMWPE humeral head supports the use of non-spherical non-conforming bearings with inverted conventional materials in anatomic total shoulder arthroplasty.

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.

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
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