Table 2: Advantages and Disadvantages of Linked and Unlinked Prosthesis

Linked Unlinked
Advantages
  • Ensure joint stability
  • May be used in the presence of ligamentous insufficiency
  • May be used in the presence of severe bone loss
  • Better range of motion (soft-tissue release and non-anatomic implantation)
  • Less constrained implants may be associated with a lower risk of wear, loosening and osteolysis
  • Less bony-invasive, which may be beneficial if revision or resection are required
  • Some anatomic humeral components may be used as hemiarthroplasty
Disadvantages
  • Increased constrained may result in increased tension to the interface and higher risk of mechanical failure secondary to wear and/or loosening
  • More extensive canal invasion, potentially complicating revision surgery
  • Cannot be used as hemiarthroplasty
  • Component linking may make implantation more difficult
  • Possible failure of the linking mechanism
  • Most require more accurate component positioning in order to ensure proper articular tracking
  • It is possible to subluxate or dislocate the joint
  • Difficult to use when there is the need to compensate for bone loss or ligamentous insufficiency
  • Limited ability for soft-tissue release or non-anatomic implant positioning in patients with stiffness