Investigators: Professor Andrew Amis, Mr Roger Emrey, Mr Toby Baring
Stream: Clinical Fellowship
Topic: Upper Limbs (Shoulder)
Status: Completed
The primary reason for most total shoulder arthroplasty failures us glenoid loosening, for which the mechanism still remains unclear. This study aimed to identify which part of the fixation is responsible for glenoid component failure, the implant-cement interface, the cement-bone interface or the adjacent bone by using CT-scanning. The study also aimed to determine the respective roles of compression and distraction forces in the initiation of the failure and its subsequent progression around the glenoid implant until complete failure. We have shown that CT scanning can be used to characterise glenoid fixation failure. The observed failure occurs at the implant-cement interface. The loosening initiated inferiorly and superiorly at the edges of the glenoid rim progression to the keel, which is consistent with the rocking horse mechanism. Both compressive and distractive forces are involved in the initiation and propagation of loosening.
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