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Published in: Clin Biomech, vol. 20, num. 7, p. 710-7 Publication date: 2005

BACKGROUND: Although shoulder arthroplasty is an accepted treatment for osteoarthritis, loosening of the glenoid component, which mainly occurs at the bone-cement interface, remains a major concern. Presently, the mechanical effect of the cement mantel thickness on the bone-cement interface is still unclear. METHODS: Finite element analysis of a prosthetic scapula was used to evaluate the effect of cement thickness on stresses and micromotions at the bone-cement interface. The glenoid component was all-polyethylene, keeled and flat back. Cement mantel thickness was gradually increased from 0.5 to 2.0 mm. Two glenohumeral contact forces were applied: concentric and eccentric. Two extreme cases were considered for the bone-cement interface: bonded and debonded. FINDINGS: Within cement, stress increased as cement thickness decreased, reaching the fatigue limit below 1.0 mm. Bone stress was below its ultimate strength and was minimum between 1.0 and 1.5mm. Interface stress was close to the interface strength, and also minimum between 1.0 and 1.5 mm. Both the decentring of the load and the debonding of the interface increased the stress. INTERPRETATION: A cement thinning weakens the cement, but also the bone-cement interface, along the back-keel edges. Conversely, a cement thickening rigidifies the cemented implant, consequently increasing interfacial stresses and micromotions. To avoid both excessive cement fatigue and interface failure, an ideal cement thickness has been identified between 1.0 and 1.5 mm.

Keywords: Bone Cements/analysis/*chemistry ; Cementation/*methods ; Comparative Study ; Compressive Strength ; Computer Simulation ; Elasticity ; Equipment Failure Analysis/methods ; Humans ; *Joint Prosthesis ; Materials Testing/methods ; *Models ; Biological ; Models ; Chemical ; Prosthesis Implantation/*methods ; Shoulder Joint/*chemistry/*physiopathology/surgery ; Stress ; Mechanical ; Tensile Strength ; Therapy ; Computer-Assisted/*methods ; Models Note: Laboratoire de Recherche en Orthopedie, STI-IGBM-LRO, Batiment AA.B, Station 15, Ecole Polytechnique Federale de Lausanne (EPFL), 1015 Lausanne, Switzerland. alexandre.terrier[at] 0268-0033 (Print) Evaluation Studies Journal Article Reference LBO-ARTICLE-2005-007View record in Web of Science

Autor: Terrier, Alexandre; Buchler, Philippe; Farron, Alain


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