Cementless Prosthetic Fixation: When Less is More-In Opposition

Cemented fixation for the humeral and glenoid components in shoulder arthroplasty remains the standard to which all other methods of fixation must be compared. The incidence of loosening of humeral components regardless of fixation is very low, but when directly compared, cemented humeral components have been shown to have a lower incidence of radiographic loosening than uncemented humeral components. On the glenoid side, although there is an increased incidence of radiolucent lines in cemented all-polyethylene components, the rate of clinical loosening and failure is lower when compared with cementless metal-backed components. Multiple peer-reviewed publications have concluded that cemented all-polyethylene glenoid components exhibit lower rates of clinical loosening compared with cementless designs.