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

• Verfasst von: Sowa, Boris [VerfasserIn]
• Verfasst von: Bochenek, Martin [VerfasserIn]
• Verfasst von: Braun, Steffen [VerfasserIn]
• Verfasst von: Kretzer, Jan Philippe [VerfasserIn]
• Verfasst von: Zeifang, Felix [VerfasserIn]
• Verfasst von: Bruckner, Thomas [VerfasserIn]
• Verfasst von: Walch, Gilles [VerfasserIn]
• Verfasst von: Raiss, Patric [VerfasserIn]
• Titel: The subchondral bone layer and glenoid implant design are relevant for primary stability in glenoid arthroplasty
• Verf.angabe: Boris Sowa, Martin Bochenek, Steffen Braun, Jan Philippe Kretzer, Felix Zeifang, Thomas Bruckner, Gilles Walch & Patric Raiss
• E-Jahr: 2018
• Jahr: 04 July 2018
• Umfang: 8 S.
• Fussnoten: Gesehen am 01.04.2020
• Titel Quelle: Enthalten in: Archives of orthopaedic and trauma surgery
• Ort Quelle: Berlin : Springer, 1903
• Jahr Quelle: 2018
• Band/Heft Quelle: 138(2018), 11, Seite 1487-1494
• ISSN Quelle: 1434-3916
• DOI: doi:10.1007/s00402-018-2990-1
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: A1
• Sach-SW: Anatomic
• Sach-SW: Arthroplasty, Replacement, Shoulder
• Sach-SW: Biomechanical Phenomena
• Sach-SW: Glenoid
• Sach-SW: Glenoid Cavity
• Sach-SW: Humans
• Sach-SW: Models, Anatomic
• Sach-SW: Prosthesis Design
• Sach-SW: Reaming
• Sach-SW: Shoulder Joint
• Sach-SW: Shoulder Prosthesis
• Sach-SW: Subchondral
• Sach-SW: TSA
• K10plus-PPN: 1693691167

Abstract

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.