Influence of peg design and cement mantle thickness on pull-out strength of glenoid component pegs.

Fixation of the glenoid component is critical to the outcome of total shoulder arthroplasty. In an in vitro study, we analysed the effect of surface design and thickness of the cement mantle on the pull-out strength of the polyethylene pegs which are considered essential for fixation of cemented glenoid components. The macrostructure and surface of the pegs and the thickness of the cement mantle were studied in human glenoid bone. The lowest pull-out forces, 20 +/- 5 N, were for cylindrical pegs with a smooth surface fixed in the glenoid with a thin cement mantle. The highest values, 425 +/- 7 N, were for threaded pegs fixed with a thicker cement mantle. Increasing the diameter of the hole into which the peg is inserted from 5.2 to 6.2 mm thereby increasing the thickness of the cement mantle, improved the mean pull-out force for the pegs tested.

[1]  M. Freeman,et al.  The fixation of a proximal tibial polyethylene prosthesis without cement. , 1982, The Journal of bone and joint surgery. British volume.

[2]  B. Norris,et al.  Modern Cement Technique and the Survivorship of Total Shoulder Arthroplasty , 1996, Clinical orthopaedics and related research.

[3]  R. Volz,et al.  The mechanical stability of various noncemented tibial components. , 1988, Clinical orthopaedics and related research.

[4]  C A Rockwood,et al.  Complications of total shoulder-replacement arthroplasty. , 1996, The Journal of bone and joint surgery. American volume.

[5]  E. Chao,et al.  Biomechanical analysis of stability and fixation strength of total shoulder prostheses. , 1988, Orthopedics.

[6]  D R Pichora,et al.  Mechanical testing of shoulder prostheses and recommendations for glenoid design. , 2000, Journal of shoulder and elbow surgery.

[7]  M. Semlitsch,et al.  The morphology of polymethylmethacrylate (PMMA) bone cement: surface structures and causes of their origin. , 1979, Archives of orthopaedic and traumatic surgery. Archiv fur orthopadische und Unfall-Chirurgie.

[8]  F A Matsen,et al.  Glenoid loosening in total shoulder arthroplasty. Association with rotator cuff deficiency. , 1988, The Journal of arthroplasty.

[9]  J. O. Søjbjerg,et al.  Bone strength and material properties of the glenoid. , 1997, Journal of shoulder and elbow surgery.

[10]  P. Boutemy,et al.  Primary Fixation of Glenoid Implants: An In Vitro Study , 1999 .

[11]  R. Bourne,et al.  Analysis of the pull-out strength of screws and pegs used to secure tibial components following total knee arthroplasty. , 1989, Clinical orthopaedics and related research.

[12]  G. Beaupré,et al.  The influence of fixation peg design on the shear stability of prosthetic implants , 1990, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[13]  M. Post Constrained arthroplasty of the shoulder. , 1987, The Orthopedic clinics of North America.

[14]  G. Lewis,et al.  Properties of acrylic bone cement: state of the art review. , 1997, Journal of biomedical materials research.

[15]  J A Sidles,et al.  Translation of the humeral head on the glenoid with passive glenohumeral motion. , 1990, The Journal of bone and joint surgery. American volume.