Which of the following is a key consideration in glenoid component placement to prevent loosening?

• A. Avoid slight superior tilt for better contact.
• B. Achieve correct version and tilt, secure fixation, adequate bone stock, and avoid superior tilt.
• C. Use only cementless fixation regardless of bone stock.
• D. Accept large version errors to simplify surgery.

Answer: (B)

The main idea is that long-term stability of a glenoid component depends on proper alignment and solid fixation. When the glenoid is placed with the correct version and tilt, and the fixation is secure with enough bone stock, the load from the joint is distributed evenly across the implant and bone. This minimizes micromotion at the bone-implant interface, which is a primary driver of loosening over time. Avoiding superior tilt is important because tilting the component upward shifts loading toward the superior rim, increasing stress at the fixation and weakening the seal between implant and bone. Adequate bone stock provides a solid foundation for either a cemented or cementless fixation, ensuring durable seating of the component. In short, achieving correct version and tilt, securing fixation, ensuring adequate bone stock, and avoiding superior tilt collectively reduce the risk of loosening.