MODERN CEMENT TECHNIQUE AND THE SURVIVORSHIP OF TOTAL SHOULDER ARTHROPLASTY

Thirty-eight consecutive Neer II total shoulder arthroplasties were pe rformed in 35 patients by one surgeon using the so caned modern cement technique and followed for a mean of 5 years (range, 2-9.5 years), Th e preoperative diagnosis was osteoarthritis or avascular necrosis in 2 2 shoulders, rheumatoid arthritis in 10 shoulders, and posttraumatic a rthritis in 6 shoulders, The components were implanted using specific improved techniques for cement fixation initially described for total hip arthroplasty. Twenty-six metal-backed and 12 polyethylene glenoid components were used, The humeral component was implanted with cement in 32 shoulders, There were no intraoperative fractures or postoperati ve neurapraxias. At most recent follow up, 36 shoulders had no or slig ht pain with activity. The mean increase in active forward elevation w as 38 degrees and in active external rotation was 29 degrees, There ha ve been no revisions, and all components remain in place. With failure defined as definite radiographic loosening of the components, there w as 97% survivorship at 5 years, and 93% at 8 years, Radiolucent lines around more than 50% of the bone cement interface of the humeral compo nent were present in only 3 shoulders, Radiolucent lines around more t han 50% of the bone cement interface of the glenoid component were see n in only 2 shoulders. Both components in 1 severely osteopenic should er had a complete radiolucent line and a change in position, Meticulou s attention to cement technique mag improve the long term survival of cemented total shoulder arthroplasty components.