The case for the metal-backed glenoid design in total anatomical shoulder arthroplasty

After 38 years of unchallenged reign of cemented full polyethylene glenoid implants, the main problem of anatomical shoulder arthroplasty is still glenoid loosening, also the main cause of failure. A certain concern regarding uncemented metal back components in total anatomical shoulder arthroplasty has developed, due to problems evoked in the literature. This work is a comprehensive bibliographical review of the different clinical and biomechanical studies of noncemented glenoid implants. Those publications often showed a high rate of failure of uncemented glenoid implants, but their arguments appeared often theoretical or based on old and/or nonadapted devices. In conclusion, the authors emphasise that research on new designs of metal back components needs to go on.