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05.05.2022 | Review Article

The glenoid: a weak link in total shoulder arthroplasty

Metal backs as possible solutions and future perspectives

verfasst von: Alessandro Castagna, Giacomo Delle Rose, Mario Borroni, Stefano Gumina, Raffaele Garofalo, Riccardo Ranieri, MD

Erschienen in: Obere Extremität | Ausgabe 2/2022

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Abstract

Background

Glenoid component loosening and failure remains the most common complication of total shoulder arthroplasty (TSA). All-polyethylene (PE) glenoids have shown considerable rates for progressive radiolucent lines (RLL) and glenoid loosening. Metal-backed glenoids (MBGs) where introduced in attempt to improved glenoid fixation, but controversial results are reported in the literature. The aim of this article was to summarize the state of art of MBGs and modern glenoid solutions in TSA.

Materials and methods

A selective PubMed literature search was performed in order to analyze the rationale behind MBG, reporting current biomechanical and clinical evidences and exploring potential future directions.

Results

Several different MBGs were introduced since the first uncemented MBG presented by Cofield. Most of them were abandoned due to high revision rate and unsatisfactory survival rate. Main implant-related complications involved component or screw breakage, component dissociation, PE and metal wear. Most of these problems were solved by the design evolution. PE wear remains the main problem, but new convertible platforms allow easy revision to reverse prosthesis maintaining the metal baseplate with good clinical results.

Conclusion

Clinical results regarding MBGs are controversial and confused, mainly due to the fact that several designs were introduced in the past with crucial differences among them. Even if modern designs presented better results and solved some common complications encountered with old MBGs, the field of the glenoid in anatomic replacement remains the main space for innovation in shoulder arthroplasty.

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Titel: The glenoid: a weak link in total shoulder arthroplasty
Metal backs as possible solutions and future perspectives
verfasst von: Alessandro Castagna
Giacomo Delle Rose
Mario Borroni
Stefano Gumina
Raffaele Garofalo
Riccardo Ranieri, MD
Publikationsdatum: 05.05.2022
Verlag: Springer Medizin
Erschienen in: Obere Extremität / Ausgabe 2/2022
Print ISSN: 1862-6599
Elektronische ISSN: 1862-6602
DOI: https://doi.org/10.1007/s11678-022-00690-z

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