Effect of glenoid component inclination on its fixation and humeral head subluxation in total shoulder arthroplasty

Objective. To investigate the effect of glenoid component inclination angle on the fixation of cemented glenoid-bone structures and humeral head subluxation. Background. Results of shoulder replacements, in terms of glenoid component fixation and joint functionality, are bad and must be improved. Repeated glenoid component tilting, a result of eccentric contact forces harms glenoid component fixation. However, the effect of glenoid component inclination is unknown. Methods. Keeled glenoid components are cemented into bone substitutes and positioned under inclination angles varying between −4.5° and +4.5°. For each inclination angle 5 glenoid specimens are loaded by a horizontal, constant joint compression force (725 (SD 10) N) and a vertical, superior directed subluxation force (shear force), cyclically varying between 0 and 350 (SD 1) N. After 200,000 load cycles, the upper and lower glenoid component rim-displacements are measured during 1500 additional load cycles by custom made displacement sensors. Results. The maximal superior rim-displacement significantly increased and the minimal inferior rim-displacement dramatically decreased for increasing glenoid component inclination angles up to +4.5°. Maximal ratio of subluxation force over compression force significantly decreased for increasing glenoid component inclination. Conclusions. According to this study, decreasing glenoid component inclination angle decreases glenoid component tilting and humeral head subluxation and the results can be used to improve total shoulder replacements. Relevance Better understanding of the effect of glenoid component inclination on glenoid component tilting and humeral head subluxation may be useful information for the surgeon to improve results of the total shoulder arthroplasty, when replacing the glenoid surface.