Development and Assessment of 3-Dimensional CT Measures of Proximal Humeral Bone Density: A Comparison to Established 2D Measures and Intraoperative Findings in Patients Undergoing Shoulder Arthroplasty

William G. Blakeney ◽  
Manuel Urvoy ◽  
Jean Chaoui ◽  
Patric Raiss ◽  
George Athwal ◽  
Werner Pomwenger ◽  
Karl Entacher ◽  
Herbert Resch ◽  
Peter Schuller-Götzburg

AbstractTreatment of common pathologies of the shoulder complex, such as rheumatoid arthritis and osteoporosis, is usually performed by total shoulder arthroplasty (TSA). Survival of the glenoid component is still a problem in TSA, whereas the humeral component is rarely subject to failure. To set up a finite element analysis (FEA) for simulation of a TSA in order to gain insight into the mechanical behaviour of a glenoid implant, the modelling procedure and the application of boundary conditions are of major importance because the computed result strongly depends upon the accuracy and sense of realism of the model. The goal of this study was to show the influence on glenoid stress distribution of a patient-specific bone density distribution compared with a homogenous bone density distribution for the purpose of generating a valid model in future FEA studies of the shoulder complex. Detailed information on the integration of bone density properties using existing numerical models as well as the applied boundary conditions is provided. A novel approach involving statistical analysis of values derived from an FEA is demonstrated using a cumulative distribution function. The results show well the mechanically superior behaviour of a realistic bone density distribution and therefore emphasise the necessity for patient-specific simulations in biomechanical and medical simulations.

2021 ◽  
Jacob Reeves ◽  
Tom Vanasse ◽  
Christopher Roche ◽  
Kenneth J. Faber ◽  
G. Daniel G. Langohr

Abstract During shoulder arthroplasty, surgeons must select the optimal implant for each patient. The metaphyseal bone properties affect this decision; however, the typical resection 'thumb test' lacks objectivity. The purposes of this investigation were: to determine the correlation strength between the indentation depth of a handheld mechanism and the density, compressive strength and modulus of a bone surrogate; as well as to assess how changing the indenter tip shape and impact energy may affect the correlation strengths. A spring-loaded indenter was developed. Four tip shapes (needle, tapered, flat and radiused cylinders) and four spring energies (0.13J-0.76J) were assessed by indenting five cellular foam bone surrogates of varying density. The indentation depth was measured and correlated with apparent density, compressive strength and modulus. Indentation depth plateaued as the bone surrogate's material properties increased, particularly for indentation tips with larger footprints and the 0.13J spring. All tip shapes produced strong (R2≥0.7) power-law relationships between the indentation depth metric and the bone surrogate's material properties (density: 0.70 ≤ R2 ≤ 0.95, strength: 0.75 ≤ R2 ≤ 0.97, modulus: 0.70 ≤ R2 ≤ 0.93); though use of the needle tip yielded the widest indentation depth scale. These strong correlations suggest that a handheld indenter may provide objective intraoperative evidence of cancellous material properties. Further investigations are warranted to study indenter tip shape and spring energy in human tissue; though the needle tip with spring energy between 0.30J and 0.76J seems the most promising.

2013 ◽  
Vol 24 (5) ◽  
pp. 753-761 ◽  
Giovanni Merolla ◽  
Barbara Amore ◽  
Paolo Paladini ◽  
Enrico Cavagna ◽  
Giuseppe Porcellini

2018 ◽  
Vol 2 (3) ◽  
pp. 174-181 ◽  
Matt A. Daalder ◽  
Gabriel Venne ◽  
Varun Sharma ◽  
Michael Rainbow ◽  
Timothy Bryant ◽  

2018 ◽  
Vol 27 (6) ◽  
pp. 983-992 ◽  
Eric T. Ricchetti ◽  
Bong-Jae Jun ◽  
Richard A. Cain ◽  
Ari Youderian ◽  
Eric J. Rodriguez ◽  

2010 ◽  
Vol 19 (5) ◽  
pp. 664-669 ◽  
Levi G. Sutton ◽  
Frederick W. Werner ◽  
Alyssa K. Jones ◽  
Christopher A. Close ◽  
Vipul N. Nanavati

2015 ◽  
Vol 24 (3) ◽  
pp. 416-424 ◽  
Peter Simon ◽  
Anil Gupta ◽  
Ioannis Pappou ◽  
Michael M. Hussey ◽  
Brandon G. Santoni ◽  

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