title: Porous metals and alternate bearing surfaces in shoulder arthroplasty.
abstract: Total shoulder arthroplasty (TSA) provides an effective solution for the treatment of glenohumeral arthritis. However, long-term outcomes have been limited by glenoid component aseptic loosening and polyethylene (PE) wear. Previous attempts to improve glenoid fixation with metal-backed glenoids resulted in inferior results. Newer component designs that contain porous metal allow for biological ingrowth of the prosthesis, potentially improving longevity and overall outcomes. Porous metal can also improve humeral component fixation, obviating the need for cement and simplifying revision surgery. Advances such as highly cross-linked polyethylene (HXLPE), vitamin E-doped HXLPE, and alternate bearing surfaces like ceramics and pyrolytic carbon have proven to provide superior wear characteristics in other joint replacements and may prove beneficial in the shoulder as well.
authors.affiliation: Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, 3333 North Calvert Street, Suite 400, Baltimore, MD, 21218, USA.
authors.forename: Shannon R
authors.initials: SR
authors.lastname: Carpenter
authors.affiliation: Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, 3333 North Calvert Street, Suite 400, Baltimore, MD, 21218, USA.
authors.forename: Ivan
authors.initials: I
authors.lastname: Urits
authors.affiliation: Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, 3333 North Calvert Street, Suite 400, Baltimore, MD, 21218, USA. lyn.camire@medstar.net.
authors.forename: Anand M
authors.initials: AM
authors.lastname: Murthi
keywords: Glenoid component failure; Porous metal; Pyrolytic carbon; Stemless arthroplasty; Total shoulder arthroplasty; Trabecular metal