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. 2011 Dec;35(12):1813-9.
doi: 10.1007/s00264-011-1308-5. Epub 2011 Jul 7.

Mineralisation and mechanical strength of the glenoid cavity subchondral bone plate

Marko Kraljević  1 , Valentin Zumstein, Dieter Wirz, Rolf Hügli, Magdalena Müller-Gerbl
Affiliations

Mineralisation and mechanical strength of the glenoid cavity subchondral bone plate

Marko Kraljević et al. Int Orthop. 2011 Dec.

Abstract

Purpose: Failures in total shoulder replacements are often due to aseptic loosening of the glenoid component; the subchondral bone plate is an important factor governing primary fixation of implant materials. Therefore, we investigated characteristic mineralisation patterns of the subchondral bone plate, which demonstrate long-term stress on articular surfaces, age-related changes, postsurgical biomechanical situations and regions of fixation. Using computed tomography osteo-absorptiometry (CT-OAM), these distribution patterns can be demonstrated in vivo. The aim of this study was to investigate the relationship between subchondral bone-plate mineralisation measured with CT-OAM and the mechanical strength measured by indentation.

Methods: A total of 32 cadaverous glenoid cavities were evaluated by CT-OAM and indentation testing. Linear regression was used to compare mineralisation and strength of the subchondral bone plate.

Results: Results showed two patterns of mineralisation distribution. Twenty-eight cavities were related to bicentric distribution pattern and four showed a single maximum. The correlation coefficient between CT-OAM density and subchondral bone-plate strength was determined to be between 0.62 and 0.96 (P < 0.02).

Conclusions: Long-term stress affects not only the subchondral but also the underlying cancellous bone. It therefore can be assumed that mineralisation patterns of the subchondral bone plate continue in cancellous bone. Areas of high density could serve as anchoring locations for orthopaedic implants in resurfacing the glenoid cavity.

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Figures

Fig. 1
Fig. 1
a Density distribution of the subchondral bone plate was analysed by maximum intensity projection and visualised with false colours. Black typified density values >1,200 HU, followed in descending order by red, orange, yellow, green and blue <200 HU. b The subchondral bone plate was indented 16 times using a 1.3 mm diameter steel needle
Fig. 2
Fig. 2
a Twenty-eight glenoid cavities showed a bicentric density distribution. Blue circles represent posterior and red squares anterior peak values; left glenoids are mirrored. b Only four glenoid cavities showed a monocentric density distribution; triangles represent peak values
Fig. 3
Fig. 3
Twenty-eight glenoid cavities showed a bicentric (left image) strength distribution; only four glenoid cavities showed a monocentric (right image) strength distribution
Fig. 4
Fig. 4
Distribution of mineral density (left image) and distribution of strength (right image) of the glenoid cavity
Fig. 5
Fig. 5
Correlation between strength and density on one glenoid cavity
See this image and copyright information in PMC

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