This 1994 narrative review by Cofield synthesizes published literature and Mayo Clinic institutional data (180 tissue ingrowth glenoid components, 1989–1993) to evaluate uncemented fixation strategies for both humeral and glenoid components in total shoulder arthroplasty, asking whether press-fit or tissue ingrowth fixation can match the durability of cemented fixation.
When selecting glenoid fixation in TSA, recognize that cemented components have a well-documented radiographic loosening burden (≥50% in some series) while tissue ingrowth components trade that problem for a lower but distinct risk of accelerated posterior polyethylene wear — and in both cases, bone quality and quantity in the glenoid fossa remain the primary drivers of fixation choice.
Avoid press-fitted humeral components in TSA: the long-term loosening data disqualifies them, even though they perform acceptably for isolated humeral head replacement.
This 1994 narrative review by Cofield synthesizes published literature and Mayo Clinic institutional data (180 tissue ingrowth glenoid components, 1989–1993) to evaluate uncemented fixation strategies for both humeral and glenoid components in total shoulder arthroplasty, asking whether press-fit or tissue ingrowth fixation can match the durability of cemented fixation.
When selecting glenoid fixation in TSA, recognize that cemented components have a well-documented radiographic loosening burden (≥50% in some series) while tissue ingrowth components trade that problem for a lower but distinct risk of accelerated posterior polyethylene wear — and in both cases, bone quality and quantity in the glenoid fossa remain the primary drivers of fixation choice.
Avoid press-fitted humeral components in TSA: the long-term loosening data disqualifies them, even though they perform acceptably for isolated humeral head replacement.