Current Concepts Review by Matsen et al. (2008) synthesizing peer-reviewed evidence on why glenoid components fail in total shoulder arthroplasty — the procedure's most common complication. The paper organizes failure mechanisms into five modes and derives prevention strategies from each.
When a TSA produces pain, clunking, or loss of function, systematically work through the five failure modes using scapular-plane and axillary radiographs — look for radiolucent line progression, rocking-horse loosening pattern, polyethylene thinning, and component malposition.
At primary TSA, choose a round-backed all-polyethylene pegged component, ream to a non-conforming concavity, restore neutral version, and dry the fixation holes meticulously before cementing to minimize your starting radiolucent line burden.
Current Concepts Review by Matsen et al. (2008) synthesizing peer-reviewed evidence on why glenoid components fail in total shoulder arthroplasty — the procedure's most common complication. The paper organizes failure mechanisms into five modes and derives prevention strategies from each.
When a TSA produces pain, clunking, or loss of function, systematically work through the five failure modes using scapular-plane and axillary radiographs — look for radiolucent line progression, rocking-horse loosening pattern, polyethylene thinning, and component malposition.
At primary TSA, choose a round-backed all-polyethylene pegged component, ream to a non-conforming concavity, restore neutral version, and dry the fixation holes meticulously before cementing to minimize your starting radiolucent line burden.