This is a retrospective review of 83 total shoulder arthroplasties using a metal-backed, bone-ingrowth glenoid component instead of a cemented one. The design was meant to improve fixation and implant survival over cemented glenoids. The study asks how these components perform over medium to long-term follow-up.
For most primary total shoulder arthroplasty, cement an all-polyethylene glenoid rather than reaching for a metal-backed ingrowth design.
The reasoning is mechanical. Metal backing raises stress in the overlying polyethylene, which accelerates wear. Once the poly wears through, the humeral head runs on the metal tray, generating debris, osteolysis, and loosening. Each stage feeds the next, so failures keep accruing and the ten-year survival collapses to about 52%.
Watch the endpoint you trust. Revision-only survival here was 78.5% at ten years, but adding radiographic failure dropped it to 51.9%. Radiographic wear and loosening precede clinical revision, so a low reoperation rate can hide a failing implant.
Reserve metal-backed ingrowth glenoids for special situations such as focal glenoid bone loss, scapular dysplasia, or revision with central glenoid deficiency where a cemented component cannot be seated.
This is a retrospective review of 83 total shoulder arthroplasties using a metal-backed, bone-ingrowth glenoid component instead of a cemented one. The design was meant to improve fixation and implant survival over cemented glenoids. The study asks how these components perform over medium to long-term follow-up.
For most primary total shoulder arthroplasty, cement an all-polyethylene glenoid rather than reaching for a metal-backed ingrowth design.
The reasoning is mechanical. Metal backing raises stress in the overlying polyethylene, which accelerates wear. Once the poly wears through, the humeral head runs on the metal tray, generating debris, osteolysis, and loosening. Each stage feeds the next, so failures keep accruing and the ten-year survival collapses to about 52%.
Watch the endpoint you trust. Revision-only survival here was 78.5% at ten years, but adding radiographic failure dropped it to 51.9%. Radiographic wear and loosening precede clinical revision, so a low reoperation rate can hide a failing implant.
Reserve metal-backed ingrowth glenoids for special situations such as focal glenoid bone loss, scapular dysplasia, or revision with central glenoid deficiency where a cemented component cannot be seated.