A prototypal stainless steel cross-keeled glenoid component was designed and implanted in ten cadaveric scapulae. A pneumatic testing apparatus was employed to test implant stability utilizing four Linear Variable Differential Transducers, or LVDTs, to measure implant micromotion relative to the bone. Testing variables included six directions and three angles of load application, three component thicknesses, and six fixation modalities unkeeled, small, medium and large cross-keels, supplemental screws and bone cement. The component displayed a consistent response to loading, with compression at the side of load application and distraction at the contralateral side, characteristic of a rigid body on an elastic medium. The presence of any type of fixation resulted in greater stability when compared with the unkeeled component. The use of screw and cement fixation resulted in the most stable fixation of the methods investigated (p<0.05). Greater stability was found with decreasing component thickness (p<0.05) and decreasing angle of load application (p<0.05). Both these results can, in all likelihood, be attributed to the change in the resultant load vector, or the line of action of the joint load. With micromotion measurements in the range of 60 to 80 micrometres, this prototypal stainless steel cross- keeled glenoid component demonstrated increased stability over previous studies of polyethylene components.
Keywords:
upper extremity; implant stability; glenohumeral; implant design; shoulder; fixation