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Orthopaedics & Traumatology: Surgery & Research
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le lundi 24 décembre 2018
Doi : 10.1016/j.otsr.2018.10.006
Received : 29 January 2018 ;  accepted : 26 October 2018
Cement augmentation of glenoid baseplate screws does not improve primary stability in reversed shoulder arthroplasty: A cadaveric study
 

Benjamin Bockmann a, Martin Bäumlein b, Rainer Koch b, Jens Figiel c, Philipp Lechler b, René Aigner b, Christopher Bliemel b, Ludwig Oberkircher b, Steffen Ruchholtz b, Michael Frink b,
a Department of Orthopaedics and Trauma Surgery, St. Josef Hospital, Ruhr University Bochum, Germany 
b Center for Orthopeadics and Trauma Surgery, University Hospital Gießen and Marburg, 35043 Marburg, Germany 
c Department of Diagnostic and Interventional Radiology, University Hospital Gießen and Marburg, 35043 Marburg, Germany 

Corresponding author.
Abstract
Introduction

Cuff tear arthritis and complex proximal humeral fractures are common pathologies that are frequently addressed by the implantation of a reversed shoulder prosthesis. The present cadaveric study aimed to analyze the effect of cement augmentation of the glenoid component on the primary stability in geriatric patients.

Hypothesis

Cement augmentation of glenoid baseplate screws has an influence on primary stability in reversed shoulder arthroplasty (RSA).

Materials and methods

Glenoid base plates (Delta Xtend, DePuy Synthes, Westchester, USA) were implanted in 6 pairs of formalin-fixated scapulae of 4 female and 2 male donors (average age 83 years). Two angle stable screws were placed at the superior and inferior position. Cement augmentation was performed with 2ml bone cement (Kyphon, Medtronic, Minneapolis, USA) per screw in right specimens. Afterwards, biomechanical testing with 600 to 1000N (100 cycles) at a 65° abduction angle was performed. Finally, a load-to-failure analysis was conducted.

Results

No implant loosening was observed during cyclic tests from 600N to 1000N. In addition no difference in the plastic deformation was detected at 600N (p =0.301), 700N (p =0.522), 800N (p =0.480), 900N (p =0.521) and 1000N (p =0.748). Load-to-failure analyses revealed implant loosening at 3314N (SD 823N) in the cement-augmented implants and at 3059N (SD 974N) in scapulae with non-cemented screws (p =0.522).

Discussion

Cement-augmented fixation of the glenoid component did not result in an increased primary stability in this study. Thus, the application of cement should be critically assessed considering associated risks and increased costs.

Level of proof

Basic science study, controlled laboratory study.

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Keywords : Reverse shoulder arthroplasty, Glenoid fixation, Cement, Augmentation, Primary stability




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