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Prosthetic Bearing Surfaces in Anatomic and Reverse Total Shoulder Arthroplasty

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.5435/JAAOS-D-20-00166

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Total shoulder arthroplasty (TSA) and reverse TSA are effective treatments for glenohumeral osteoarthritis, but longevity may be limited by osteolysis and polyethylene wear. New bearing surfaces like highly cross-linked ultra-high-molecular-weight polyethylene, vitamin E processing, ceramic heads, and pyrolytic carbon surfaces have shown improved wear characteristics in studies.
Total shoulder arthroplasty (TSA) and reverse TSA have provided an effective treatment for glenohumeral osteoarthritis; however, longevity of the procedure may be limited by osteolysis and polyethylene wear. In TSA, glenoid component failure occurs through several mechanisms, the most common being aseptic loosening and polyethylene wear. Newer bearing surfaces such as highly cross-linked ultra-high-molecular-weight polyethylene, vitamin E processing, ceramic heads, and pyrolytic carbon surfaces have shown improved wear characteristics in biomechanical and some early clinical studies. The purpose of this review is to provide a historical perspective and current state of the art of bearing surface technology in anatomic and reverse TSA.

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