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

Philip Kasten1, Patric Raiss2, Felix Zeifang3

  • 1Orthopaedic Surgery Center (OCC) Tübingen, Tübingen, Germany.

Shoulder & Elbow
|March 15, 2021
PubMed
Summary

Cement pressurization into the glenoid significantly reduces radiolucent lines after total shoulder arthroplasty. This simple technique may improve the long-term survival of shoulder joint replacements.

Keywords:
arthroplastycementationlooseningpressurizershouldertechnique

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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.