Cement pressurizing reduces radiolucent lines at glenoid: A randomized, multicentric study

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering

Background:

• Total shoulder arthroplasty (TSA) is a common procedure for end-stage shoulder joint disease.
• Radiolucent lines around the glenoid component are a potential indicator of implant loosening and failure.
• Optimizing glenoid fixation is crucial for long-term TSA success.

Purpose of the Study:

• To investigate the effect of intraoperative cement pressurization into the glenoid bone on the incidence of radiolucent lines in TSA.
• To evaluate whether this technique influences clinical outcomes.

Main Methods:

• A multicentric prospective randomized study (Level of Evidence 1) was conducted.
• Group P (n=24) received intraoperative cement pressurization into the glenoid cancellous bone.
• Group NoP (n=27) received standard cement application without pressurization.
• Inclusion criteria: osteoarthritis with glenoid erosion <15° and intact rotator cuff.

Main Results:

• No significant preoperative differences were observed between groups in age, gender, range of motion, scores, or pathomorphology.
• Both groups showed significant improvements in scores, strength, motion, and satisfaction at 25.5 months post-intervention.
• Cement pressurization significantly reduced the incidence of radiolucent lines (p < 0.027).
• Clinical outcome scores were similar between the groups.

Conclusions:

• Intraoperative cement pressurization into the glenoid is an effective technique to reduce radiolucent lines in TSA.
• This simple method shows potential for improving the long-term survival of total shoulder arthroplasty.
• The findings support the routine use of glenoid cement pressurization.