Elsevier

Journal of Shoulder and Elbow Surgery

Volume 11, Issue 6, November–December 2002, Pages 614-617
Journal of Shoulder and Elbow Surgery

Original article
Fit of current glenoid component designs: An anatomic cadaver study*,**

https://doi.org/10.1067/mse.2002.126099Get rights and content

Abstract

The glenoids of 412 scapula specimens were templated with the use of 6 currently available glenoid systems to determine the goodness of fit for the various designs. When a fitting criterion of a mismatch of less than 2 mm between the template and the actual glenoid periphery for 8 radial locations was used, the various designs fit from 0% to 48% of the glenoids. Because glenoid component fixation longevity can depend on the degree of osseous support, these results indicate that glenoid component design and sizing can be improved. (J Shoulder Elbow Surg 2002;11:614-7)

Introduction

Despite the improved longevity and performance of newer shoulder prostheses, the fixation of the glenoid component remains the greatest challenge in total shoulder arthroplasty.The literature indicates that glenoid loosening represents one third of all reported complications and is the most common indication for revision.4, 5, 7, 11, 12 The interaction between the underlying osseous support of the glenoid and the component's shape and size can affect fixation longevity.1–3 By increasing the surface contact between the glenoid component/cement and underlying cortical bone and minimizing the amount of component that is unsupported, load transfer can be improved and loosening forces reduced.6, 10, 13

The purpose of this study was to template actual cadaver glenoids with currently available prosthetic glenoid components in order to assess the degree of fit provided by these various component designs and sizes.

Section snippets

Materials and methods

Four hundred twelve skeletal scapulae that had intact glenoid surfaces were provided on loan from the American Museum of Natural History in New York. The scapulae were from individuals with a mean age of 58 years (range, 24–87 years); 89% were from men, and 11% were from women. The gross appearance of the glenoid surfaces was first qualified as pear-shaped or elliptical. The scapulae were placed in an articulated holder to position the glenoid at a set orientation and reproducible distance, and

Results

Of the 412 glenoids, 71% were classified as pear-shaped and 29% as elliptical. The mean maximum height was 37.9 mm (range, 31.2–50.1 mm; SD, 2.7 mm), and the mean maximum width was 29.3 mm (range, 22.6–41.5 mm; SD, 2.4 mm); the glenoids from women were approximately 10% smaller than those from men. Eighty-five percent of all measured glenoids ranged from 34 to 42 mm high and 24 to 32 mm wide. The mean height-to-width ratio was 1.3 (SD, 0.07), which is similar to findings in a previous study.2

Discussion

The poorest direction for optimal fit of all prostheses was directly superior. This was a result of the height-to-width ratios of the components. Because the various components had height-to-width ratios ranging from 1.3 to 1.6, compared with 1.3 for the glenoids themselves, fitting the components to match the glenoid width often created overhang in the height.

The relative component shapes also influenced fit. The more ovoid designs, such as the Biomodular, Cofield 2, Kirschner/Neer, and Global

References (14)

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*

Sponsored by a grant from the National Orthopaedic Surgery Fellows Foundation.

**

Reprint requests: Fred J. Kummer, PhD, 301 E 17th St, New York, NY 10003 (E-mail: [email protected]).

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