A novel, implantable device that is less invasive and allows surgeons to perform the most challenging and complex shoulder replacements is now available at Upstate Medical University through the Upstate Bone and Joint Center.
Upstate is one of two health care facilities in New York state and among only six facilities nationwide to use the FDA-approved implantable SMR TT metal back glenoid implant for shoulder replacements.
The cup-shaped device replaces the glenoid, the cavity in the shoulder blade that connects to the head of the upper arm bone. The device allows patients who need a shoulder replacement a greater range of motion following surgery. Due to its innovative design, the device also creates a more secure and longer lasting bond by allowing for bone ingrowth.
Kevin Setter, M.D., of Upstate, is the only surgeon in New York state, outside of Buffalo, using the device. He finds the device to be significantly better than the more traditional shoulder prostheses used in shoulder replacement surgery. Setter, associate professor of orthopedic surgery at Upstate Medical University, performed America's first SMR TT metal back glenoid implant in 2014. He says that the device shows promise in creating a life-long bond between the component and the patient's bone because of its composition. It is made up of a special metal, tantilum titanium (TT), a porous material that allows bone to grow in and around the device.
"Traditional artificial glenoids use bone cement to secure the prosthesis," said Setter. "In time, the cement bone interface loosens. This may lead to pain, decreased function and possible need for revision surgery. The fixation of cemented components is greatest when first implanted. Over time this fixation will loosen. The SMR TT metal back glenoid gains its fixation from a tantalum coated peg, available in various sizes to fit anatomical needs. The hope is that with this new design, the fixation of the component will increase over time as the patient's bone grows into the implant forming a more solid bond. This in turn will hopefully lead to an improvement in already good long-term results with shoulder replacement surgery."
Setter says that the new design is especially attractive for younger patients.
"We are looking for long-term stability of these implants," Setter said. "Certainly with younger patients loosening over time is a concern. We believe with our new glenoid device, this concern will be less."
The first of the TT glenoids was implanted in Italy in October 2013. Upstate was one of two centers in the country chosen by Lima Corporate for implantation of this special prosthesis. Setter has performed complex shoulder replacement surgery in Italy, Germany, Switzerland and England and has both trained with and taught some of the most well-respected shoulder surgeons in the world.
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