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Measurement of Dynamic Scapular Kinematics Using an Acromion Marker Cluster to Minimize Skin Movement Artifact
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Interface micromotions increase with less-conforming cementless glenoid components.

Daniel R Suárez1, Willem Nerkens, Edward R Valstar

  • 1Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands. d-suarez@javeriana.edu.co

Journal of Shoulder and Elbow Surgery
|June 7, 2011
PubMed
Summary

Less conforming glenoid components in total shoulder arthroplasty lead to increased micromotions at the bone-implant interface. This may hinder bone ingrowth and implant durability, particularly with a 4mm radial mismatch.

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Area of Science:

  • Orthopedic surgery
  • Biomaterials engineering
  • Biomechanics

Background:

  • The optimal conformity of glenoid and humeral components in total shoulder arthroplasty (TSA) remains debated for maximizing performance and durability.
  • Cementless glenoid implants are used in TSA, but their interface stability is critical.

Purpose of the Study:

  • To investigate the impact of varying joint conformity on bone-implant interface micromotions in cementless glenoid components.
  • To assess the relationship between radial mismatch and micromotion magnitudes.

Main Methods:

  • Utilized polyethylene inlays with radial mismatches of 0, 2, 4, and 6 mm on a cementless metal back.
  • Conducted force-controlled experiments implanting components in a bone substitute, measuring interface micromotions and deformations.
  • Employed a finite element (FE) model to analyze micromotions across the entire bone-implant interface.

Main Results:

  • Increased radial mismatch correlated with higher measured micromotions and bone deformations.
  • A 6 mm radial mismatch resulted in significantly larger normal-to-interface micromotions compared to a fully conforming inlay.
  • FE analysis indicated significantly increased micromotions at a 4 mm radial mismatch.

Conclusions:

  • Non-conforming polyethylene inlays in cementless glenoid components generate greater interface micromotions than conforming inlays.
  • These elevated micromotions, exacerbated by humeral head translation (rocking-horse phenomenon), may impede local bone ingrowth.
  • Optimizing glenoid component conformity is crucial for achieving stable fixation and long-term success in cementless TSA.