title: An in vitro study comparing limited to full cementation of polyethylene glenoid components.
abstract: BACKGROUND
  Glenoid component survival is critical to good long-term outcomes in total shoulder arthroplasty. Optimizing the fixation environment is paramount. The purpose of this study was to compare two glenoid cementing techniques for fixation in total shoulder arthroplasty.
  
  
  METHODS
  Sixteen cadaveric specimens were randomized to receive peg-only cementation (CPEG) or full back-side cementation (CBACK). Physiological cyclic loading was performed and implant displacement was recorded using an optical tracking system. The cement mantle was examined with micro-computed tomography before and after cyclic loading.
  
  
  RESULTS
  Significantly greater implant displacement away from the inferior portion of the glenoid was observed in the peg cementation group when compared to the fully cemented group during the physiological loading. The displacement was greatest at the beginning of the loading protocol and persisted at a diminished rate during the remainder of the loading protocol. Micro-CT scanning demonstrated that the cement mantle remained intact in both groups and that three specimens in the CBACK group demonstrated microfracturing in one area only.
  
  
  CONCLUSIONS
  Displacement of the CPEG implants away from the inferior subchondral bone may represent a suboptimal condition for long-term implant survival. Cement around the back of the implant is suggested to improve initial stability of all polyethylene glenoid implants.
  
  
  CONCLUSIONS
  Full cementation provides greater implant stability when compared to limited cementation techniques for insertion of glenoid implants. Loading characteristics are more favorable when cement is placed along the entire back of the implant contacting the subchondral bone.
authors.affiliation: Department of Orthopedics, Dalhousie University, Halifax, NS, Canada. andrew_glennie@hotmail.com.
authors.forename: R Andrew
authors.initials: RA
authors.lastname: Glennie
authors.affiliation: Division of Orthopedics, Western University, 268 Grosvenor St, London, N6A 4L6, ON, Canada. giles.joshgiles@gmail.com.
authors.forename: Joshua W
authors.initials: JW
authors.lastname: Giles
authors.affiliation: Division of Orthopedics, Western University, 268 Grosvenor St, London, N6A 4L6, ON, Canada. Jim.johnson@sjhc.london.on.ca.
authors.forename: James A
authors.initials: JA
authors.lastname: Johnson
authors.affiliation: Division of Orthopedics, Western University, 268 Grosvenor St, London, N6A 4L6, ON, Canada. gsathwal@hotmail.com.
authors.forename: George S
authors.initials: GS
authors.lastname: Athwal
authors.affiliation: Division of Orthopedics, Western University, 268 Grosvenor St, London, N6A 4L6, ON, Canada. kjfaber@uwo.ca.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Faber
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002484:Cementation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020959:Polyethylene / Q000008:administration & dosage*; D011859:Radiography; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000601:surgery*; D016474:Weight-Bearing / Q000502:physiology
chemical_list: D020959:Polyethylene