Augmented glenoid component designs for type B2 erosions: A computational comparison by volume of bone removal and quality of remaining bone

Authors

Nikolas K. Knowles, St. Joseph's Health Care London
Louis M. Ferreira, St. Joseph's Health Care London
George S. Athwal, St. Joseph's Health Care London

Document Type

Article

Publication Date

1-1-2015

Journal

Journal of Shoulder and Elbow Surgery

Volume

24

Issue

8

First Page

1218

Last Page

1226

URL with Digital Object Identifier

10.1016/j.jse.2014.12.018

Abstract

© 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Background: The purpose of this computational modeling study was to compare the volume of glenoid bone removal required to implant 3 augmented component designs for management of B2 erosions. In addition, we assessed bone quality of the supporting bone directly beneath the implants by measuring bone density and porosity. Methods: Three augmented component designs-full-wedge, posterior-wedge, and posterior-step-were studied by virtual implantation in a cohort of 16 patients with B2 glenoids. B2 retroversion was corrected to 0° and 10°. The outcome variables were the volume of glenoid bone removal required for implantation and the density and porosity of the bone immediately beneath the implant. Results: Implant design had a significant effect on the volume of bone removal (P.05). Residual glenoid bone porosity was not significantly different between implants (P>.262). Conclusions: Augmented components can provide a bone-preserving option for B2 glenoid management. Substantial variations in the volume of bone removal and the quality of the remaining glenoid bone were found between 3 different designs of augmented implants. Simulations with the posterior-wedge implant resulted in substantially less glenoid bone removal, with the remaining supporting bone being of better quality.