Microcomputed tomography assessment of glenoid component cementation techniques in total shoulder arthroplasty.

Various strategies have been described to improve glenoid component cementation technique in shoulder arthroplasty, such as the "weephole" technique (WH), which is thought to allow for improved cement mantles by suction venting the glenoid vault through the coracoid. The purpose of this study was to compare the cement mantle created using standard syringe pressurization (SP) to WH or a new, modified weephole technique (MWH), not requiring specific instrumentation of the coracoid medullary canal. Fourteen cadaveric scapulae underwent preparation of the glenoid to allow for implantation of glenoid components. Component fixation was achieved using SP, WH, or MWH. The volumes of cement surrounding each individual peg on the component, of the cement mantle between the back of the glenoid, and of the reamed glenoid face were quantified using micro-CT. Compared to SP, significantly larger cement mantles were observed around all pegs with both the WH (p=0.023) and MWH (p=0.007). Similarly, both the WH and MWH techniques demonstrated significantly decreased cement behind the glenoid component (p=0.003) compared to SP, with no significant difference between the WH and the MWH techniques. Both WH and MWH techniques increase cement mantle volume around individual pegs and decrease the amount of glenoid face cement compared to conventional SP.

Hasan SA ，Cox WK ，Syed M ，Suva LJ ... -  《-》

Pressurisation leads to better cement penetration into the glenoid bone: a cadaveric study.

Raiss P ，Sowa B ，Bruckner T ，Eck S ，Woerz S ，Rohr K ，Rickert M ，Kasten P ... -  《-》

Glenoid cement mantle characterization using micro-computed tomography of three cement application techniques.

Numerous studies have documented the concern for progressive radiolucent lines, signifying debonding and subsequent aseptic loosening of the glenoid component. In this study, we compared 3 cementation methods to secure a central peg in 15 cadaveric glenoids. Cement application techniques consisted of (1) compression of multiple applications of cement using manual pressure over gauze with an Adson clamp, (2) compression of multiple applications of cement using a pressurizer device, and (3) no compression of a single application of cement. Each glenoid was then imaged with high-resolution micro-computed tomography and further processed by creating 3-dimensional computerized models of implant, bone, and cement geometry. Cement morphology characteristics were then analyzed in each of the models. There were no significant differences detected between the 2 types of compression techniques; however, there was a significant difference between compression methods and use of no compression at all. All morphologic characteristics of a larger cement mantle were significantly correlated with greater cortical contact. We demonstrate that compression techniques create a larger cement mantle. Increased size of the cement mantle is associated with increased contact with cortical bone at the glenoid vault. This method for characterizing the cement mantle by micro-computed tomography scanning techniques and 3-dimensional analysis may also be useful in future finite element analysis studies.

Flint WW ，Lewis GS ，Wee HB ，Bryce BJ ，Armstrong AD ... -  《-》

The effect of cementing technique on structural fixation of pegged glenoid components in total shoulder arthroplasty.

Nyffeler RW ，Meyer D ，Sheikh R ，Koller BJ ，Gerber C ... -  《JOURNAL OF SHOULDER AND ELBOW SURGERY》

An in vitro study comparing limited to full cementation of polyethylene glenoid components.

Glennie RA ，Giles JW ，Johnson JA ，Athwal GS ，Faber KJ ... -  《Journal of Orthopaedic Surgery and Research》