Neer Award 2017: Wear Rates of 32-mm and 40-mm Glenospheres in a Reverse Total Shoulder Arthroplasty Wear Simulation Model.

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BACKGROUND: Larger glenosphere diameters have been used recently to increase prosthesis stability and impingement-free range of motion in reverse total shoulder arthroplasty. The goal of this study was to evaluate the rate of polyethylene wear for 32-mm and 40-mm glenospheres.

METHODS: Glenospheres (32 mm and 40 mm, n = 6/group) and conventional polyethylene humeral liners underwent a 5-million cycle (MC) wear simulation protocol. Abduction-adduction and flexion-extension motion profiles were alternated every 250,000 cycles. At each interval, mass loss was determined and converted to volume loss and wear rate. At 0, 2.5 MC, and 5 MC, liners were imaged using micro-computed tomography to determine surface deviation. White light interferometry was performed on liners and glenospheres at 0 and 5 MC to quantify surface roughness. Wear particle morphology was characterized by environmental scanning electron microscopy.

RESULTS: Total volume loss was significantly higher in 40-mm liners from 1.5 MC onward (P < .05). Overall, volumetric wear rate was significantly higher in 40-mm liners compared with 32-mm glenospheres (81.7 ± 23.9 mm

CONCLUSION: Larger glenospheres underwent significantly greater polyethylene volume loss and volumetric wear rates, whereas smaller glenospheres underwent greater polyethylene surface deviations. The enhanced stability provided by larger glenospheres must be weighed against the potential for increased polyethylene wear.