Quantitative Analysis of Retrieved Glenoid Liners

Abstract

Revision of orthopedic surgeries is often expensive and involves higher risk from complications. Since most total joint replacement devices use a polyethylene bearing, which serves as a weak link, the assessment of damage to the liner due to in vivo exposure is very important. The failures often are due to excessive polyethylene wear. The glenoid liners are complex and hemispherical in shape and present challenges while assessing the damage. Therefore, the study on the analysis of glenoid liners retrieved from revision surgery may lend insight into common wear patterns and improve future product designs. The purpose of this pilot study is to further develop the methods of segmenting a liner into four quadrants to quantify the damage in the liner. Different damage modes are identified and statistically analyzed. Multiple analysts were recruited to conduct the damage assessments. In this paper, four analysts evaluated nine glenoid liners, retrieved from revision surgery, two of whom had an engineering background and two of whom had a non-engineering background. Associated human factor mechanisms are reported in this paper. The wear patterns were quantified using the Hood/Gunther, Wasielewski, Brandt, and Lombardi methods. The quantitative assessments made by several observers were analyzed. A new, composite damage parameter was developed and applied to assess damage. Inter-observer reliability was assessed using a paired t-test. Data reported by four analysts showed a high standard deviation; however, only two analysts performed the tests in a significantly similar way and they had engineering backgrounds.