Factors affecting cemented glenoid component loosening in total shoulder arthroplasty

The authors are analysing the radiological and clinical significance of radiolucent lines and their relationship with cemented glenoid component loosening in total shoulder arthroplasty (TSA). The difficulties in radiological interpretation and evaluation of radiolucency are explained. In the literature different factors were analyzed clinically or biomechanically and proposed as potential causes of radiolucency and glenoid loosening. In this paper, the influence of surgical technique and glenoid implant are analyzed. The authors draw the conclusion that cause of the glenoid loosening is probably multifactorial and if meticulous attention is given to the surgical technique for TSA, the incidence of component loosening should decrease. Greater the reliability of initial glenoid fixation, probably greater is the chance the glenoid component has to resist the negative factors promoting glenoid loosening.