Retrieved glenoid components: A classification system for surface damage analysis

There have been many reports describing modes of damage in retrieved total hip and total knee arthroplasty components. The most common mechanism in total hip arthroplasties has been shown to be surface wear. Fatigue failure shown as pitting and delamination are observed more often in total knee components. There has been no previous analysis of retrieved polyethylene glenoid components. This study evaluated the wear mechanisms contributing to failure of total shoulder glenoid components. Polyethylene glenoid components from 10 consecutive total shoulder arthroplasties have been retrieved and analyzed. Wear mechanisms were analyzed under low-power magnification, and a classification system was designed for total shoulder arthroplasties. This classification system is an adaptation of previous models of hip and knee surface damage. The severity of each damage mode was graded in 4 separate quadrants. The most prevalent damage modes were abrasion, pitting, and delamination. These data show a combination of abrasive wear and fatigue in retrieved total shoulder specimens. Surface wear and subsurface fatigue failure mechanisms both contribute to glenoid implant failure.