Is preoperative glenoid bone mineral density associated with aseptic glenoid implant loosening in anatomic total shoulder arthroplasty?

Abstract Background Aseptic loosening of glenoid implants is the primary revision cause in anatomic total shoulder arthroplasty (aTSA). While supported by biomechanical studies, impact bone quality, more specifically mineral density (BMD), on aseptic remains unclear. We hypothesized that lower preoperative BMD was associated with implant aTSA. Methods retrospectively included 93 patients (69 females and 24 males; mean age, 69.2 years) who underwent non-arthrographic computed tomography (CT) scans aTSA between 2002 2014. Preoperative (CT numbers Hounsfield unit) measured 3D using a reliable semi-automated quantitative method, following six contiguous volumes interest (VOI): cortical, subchondral cortical plate (SC), trabecular, three successive adjacent layers trabecular bone. Univariate Cox regression used to estimate loosening. further compared 26 56 matched control patients. Results Glenoid survival rates were 89% (95% confidence interval CI, 81–96%) 57% (41–74%) at 5 10 years, respectively. Hazard ratios for different VOIs ranged 0.998 1.004 CI [0.996, 1.007], p ?0.121). Only SC VOI showed significantly CTn group (622±104 HU) (658±88 ( =0.048), though medium effect size (d=0.42). There no significant differences any other from groups. Conclusions Although statistically region controls, this single-VOI difference only moderate. are thus unable prove clearly However, due its proven role survival, we recommend extending study larger CT datasets assess better understand loosening/survival outcome.