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Computed tomography quantification of bone density adjacent to cemented pegged polyethylene glenoid components in shoulder arthroplasty

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Cemented polyethylene devices are the prostheses implanted more frequently, but there is no agreement on the optimal glenoid component design. In this study, bone mineral density (BMD) adjacent to cemented all-polyethylene glenoid components was assessed to gain insights into the characteristics of glenoid bone as a potential risk factor implicated in the failure of shoulder arthroplasty.

Patients and methods

Twenty-two subjects were examined at an average follow-up of 31 months using the Constant–Murley score (CS) and multi-detector computed tomography. BMD was measured in 5 regions of interest (ROIs) at the sites where radiolucent lines are usually detected. BMD differences among the ROIs were tested. The relationship between BMD and a number of variables (CS subscores, age, gender, follow-up duration) was explored.

Results

There was a significant increase in CS scores (p < 0.05). Significantly different BMD (p = 0.0039) was found in the 5 ROIs, especially between ROIs 2 and 5 (p = 0.016, Bonferroni’s test) and between ROIs 3 and 5 (p = 0.005, Bonferroni’s test). BMD was lower in ROI 1 than ROI 3 and in ROI 2 than ROI 4, but the difference was not significant.

Discussion

The heterogeneous BMD distribution may be related to: (1) an interindividual variability in glenoid BMD; (2) the fixation technique; or (3) the different bone response to eccentric loading of the prosthetic head on the glenoid component.

Conclusions

BMD analysis may contribute to extent our knowledge on glenoid component loosening and encourage further techniques of glenoid fixation.

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Acknowledgments

We are grateful to Dr. Silvia Modena for the language revision (www.silviamodena.com). We are also grateful to Dr. Elisabetta Fabbri (U.O Ricerca ed Innovazione, AUSL Rimini, Italy) for the precious professional support in the statistical analysis. Many thanks to the Engineer Fabio Della Biancia for the valuable technical assistance in the preparation of drawings.

Conflict of interest

None.

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Authors and Affiliations

  1. Unit of Shoulder and Elbow Surgery, D. Cervesi Hospital, L.V Beethoven 1, 47841, Cattolica, RN, Italy

    Giovanni Merolla, Paolo Paladini & Giuseppe Porcellini

  2. Unit of Radiology I, Infermi Hospital, Rimini, Italy

    Barbara Amore & Enrico Cavagna

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  1. Giovanni Merolla
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  2. Barbara Amore
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  3. Paolo Paladini
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  5. Giuseppe Porcellini
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Correspondence to Giovanni Merolla.

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Merolla, G., Amore, B., Paladini, P. et al. Computed tomography quantification of bone density adjacent to cemented pegged polyethylene glenoid components in shoulder arthroplasty. Eur J Orthop Surg Traumatol 24, 753–761 (2014). https://doi.org/10.1007/s00590-013-1368-x

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  • DOI: https://doi.org/10.1007/s00590-013-1368-x

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