Hybrid fixation in anatomic shoulder arthroplasty: surgical technique and review of the literature

Hybrid constructs have been used as a primary fixation technique in primary anatomic total shoulder arthroplasty for more than a decade. A highly porous metal central peg, metal cage, or coatings attached to the surface of cemented polyethylene glenoid component have been used with the concept of providing an additional adjunct in promoting osseointegration, preventing glenoid component loosening, and promoting longer-term success. The purpose of this article is to analyze the published results, complications, as well as rate of revision using this form of glenoid fixation. In addition, key aspects of the surgical technique that may be considered to facilitate optimal results when hybrid fixation is considered in total shoulder arthroplasty are also reviewed.