Quantitative Assessment of Glenohumeral Joint Forces in Positions of Overhead Activities: Effects of Shoulder Arthroplasty

2002 ◽  
Author(s):  
Thay Q. Lee ◽  
Mark Schamblin ◽  
Bruce Y. Yang ◽  
Michelle H. McGarry ◽  
Ranjan Gupta
Keyword(s):  
Shoulder Arthroplasty ◽  
Glenohumeral Joint ◽  
Total Shoulder Arthroplasty ◽  
Glenoid Component ◽  
Shoulder Hemiarthroplasty ◽  
Adequate Pain Relief ◽  
Joint Forces ◽  
Before And After ◽  
Total Knee ◽  
Component Loosening

Glenohumeral arthroplasty as well as hemiarthroplasty, although providing adequate pain relief, has not shared in the success of similar joint replacement procedures such as total knee arthroplasty or total hip arthroplasty. Short comings of this procedure include a decreased range of motion postoperatively as well as increased incidents of glenoid component loosening in total shoulder procedures. This is especially a problem in the end ranges of motion where eccentric loading of the glenoid component are thought to occur. The purpose of this study was to quantify the glenohumeral joint forces before and after bipolar shoulder hemiarthroplasty and total shoulder arthroplasty for positions simulating overhead activities and commonly relied upon by the wheelchair dependent individual.

scholarly journals Journey of the glenoid in anatomic total shoulder replacement

2018 ◽  
Vol 11 (2) ◽  
pp. 140-148 ◽  
Author(s):  
Alessandro Castagna ◽  
Raffaele Garofalo
Keyword(s):  
Shoulder Arthroplasty ◽  
Current Practice ◽  
Total Shoulder Arthroplasty ◽  
Shoulder Function ◽  
Patient Specific ◽  
Glenoid Component ◽  
Shoulder Replacement ◽  
Final Destination ◽  
Component Loosening

Anatomic total shoulder arthroplasty (TSR) has been shown to generate good to excellent results for patients with osteoarthritis and a functioning rotator cuff. Many studies have reported that the glenoid component loosening and failure remain the most common long-term complication of total shoulder arthroplasty. The approach to glenoid component is critical because a surgeon should consider patient-specific anatomy, preserving bone stock and joint line restoration, for a good and durable shoulder function. Over the years, different glenoid design and materials have been tried in various configurations. These include cemented polyethylene, uncemented metal-backed and hybrid implants. Although advances in biomechanics, design and tribology have improved our understanding of the glenoid, the journey of the glenoid component in anatomic total shoulder arthroplasty has not yet reached its final destination. This article attempts to describe the evolution of the glenoid component in anatomic TSR and current practice.

A comparison of onlay versus inlay glenoid component loosening in total shoulder arthroplasty

2017 ◽  
Vol 26 (7) ◽  
pp. 1113-1120 ◽  
Author(s):  
Jeffrey R. Gagliano ◽  
Sarah M. Helms ◽  
Gregory P. Colbath ◽  
Breanne T. Przestrzelski ◽  
Richard J. Hawkins ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Glenoid Component ◽  
Component Loosening

Effect of Glenoid Implant Orientation and Depth on Potential Cement Failure in Total Shoulder Arthroplasty Using Finite Element Analysis

2012 ◽  
Author(s):  
Charlie Yongpravat ◽  
William N. Levine ◽  
Louis U. Bigliani ◽  
Thomas R. Gardner ◽  
Christopher S. Ahmad
Keyword(s):  
Finite Element Analysis ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Cement Mantle ◽  
Glenoid Component ◽  
Fixation Failure ◽  
Element Analysis ◽  
Component Loosening ◽  
Glenoid Erosion ◽  
Glenoid Retroversion

One of the most common complications of total shoulder arthroplasty (TSA) is glenoid component loosening due to implant-cement fixation failure. High cement stresses resulting in fracture are believed to result from malpositioning the glenoid implant [1]. Ideal glenoid preparation and placement, however, are not always achievable due to significant anatomical alterations caused by arthritis resulting in posterior glenoid erosion and increased glenoid retroversion. To our knowledge, prior research has not compared the effects of insufficient reaming depth and incomplete version correction on the likelihood of cement mantle failure. The purpose of this study was to investigate how the degree of correction of the glenoid vault affects cement mantle stress and potential cement failure.

scholarly journals Short-Term Outcomes of the Grammont Reverse Shoulder Arthroplasty: Comparison between First and Second Generation Delta Prosthesis

Joints ◽  
2021 ◽  
Author(s):  
Riccardo Luigi Alberio ◽  
Marco Landrino ◽  
Paolo Fornara ◽  
Federico Alberto Grassi
Keyword(s):  
Shoulder Arthroplasty ◽  
Second Generation ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Radiographic Evaluation ◽  
Glenoid Component ◽  
Consecutive Series ◽  
Short Term ◽  
Component Loosening

Abstract Purpose This article compares short-term outcomes of two series of patients, who underwent reverse total shoulder arthroplasty (RTSA) with two different implants, both based on Grammont's principles: the Delta III (D-3) and the Delta Xtend (D-XT) prostheses. Methods The D-3 group included a consecutive series of 26 patients (mean age 75 years), that were treated between 2000 and 2006; the D-XT group included a consecutive series of 31 patients (mean age 72.5 years), for a total of 33 implants performed between 2011 and 2015. In both groups the most common diagnoses were cuff tear arthropathy (18 and 22 shoulders, respectively) and malunion of proximal humerus fractures (3 and 5). All procedures were performed by the same surgeon. Constant–Murley score (CMS) was used to assess clinical and functional outcomes. Radiographic evaluation included the true anteroposterior and axillary views. Results Twenty-three patients of the D-3 group and 22 patients (24 shoulders) of the D-XT group were evaluated at a mean follow-up of 42 months (range 26–84) and 44 months (range 26–66), respectively. Four complications occurred in the D-3 group (1 partial deltoid detachment, 1 dislocation, and 2 glenoid component loosening), while one early postoperative infection occurred in the D-XT group. Increases in elevation and CMS between preoperative and postoperative period were observed in both groups; only the D-XT group showed a slight improvement in rotations. The incidence of scapular notching was significantly different between the two groups: 100% for D-3 and 22.2% for D-XT in patients with a minimum follow-up of 5 years. Conclusion Prosthetic design evolution and greater acquaintance with this surgery have undoubtedly led to an improvement in short-term outcomes with second generation implants of RTSA. Future studies will have to ascertain whether newer implants, relying on biomechanical solutions alternative to Grammont's original concept, might provide additional advantages and minimize drawbacks.

scholarly journals Glenoid Component Loosening in Anatomic Total Shoulder Arthroplasty: Association between Radiological Predictors and Clinical Parameters—An Observational Study

2021 ◽  
Vol 10 (2) ◽  
pp. 234
Author(s):  
Alexandra Grob ◽  
Florian Freislederer ◽  
Alex Marzel ◽  
Laurent Audigé ◽  
Hans-Kaspar Schwyzer ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Mixed Model ◽  
Constant Score ◽  
Total Shoulder Arthroplasty ◽  
Shoulder Function ◽  
Glenoid Component ◽  
Joint Gap ◽  
Acromiohumeral Distance ◽  
One Year ◽  
Component Loosening

The mechanisms of glenoid component loosening in anatomic total shoulder arthroplasty (aTSA) are still unclear, and it remains undetermined which specific radiographic features are associated with clinical outcomes. Patients with primary osteoarthritis who underwent aTSA with a stemless implant and a pegged glenoid between January 2011 and December 2016 were extracted from a local registry. Anteroposterior radiographs were evaluated at six, 12, 24 months, and five years post-TSA for lateral humeral offset (LHO), joint gap (JG), acromiohumeral distance (AHD), and radiolucency (modified Franklin score); 147 patients were included. Mixed-model linear regression was used. Both constant score (CS) and subjective shoulder value (SSV) markedly decreased at five years follow-up compared to one year (p < 0.001 for both). AHD, LHO, and JG all showed a consistent and statistically significant decline over time, with the joint gap decreasing by half. Consistently, smaller JG and AHD were correlated with lower SSV (p = 0.03 and p = 0.07, respectively). Massive loosening was associated with a 14.5 points lower SSV (p < 0.01). Finally, narrowing of the JG was significantly correlated with increased radiolucency (p < 0.001) and tended toward worse SSV (p = 0.06). In summary, radiographic parameters displaying medialization and cranialization after aTSA with a cemented pegged glenoid are useful predictors of impaired shoulder function.

scholarly journals Imaging of shoulder arthroplasties and their complications: a pictorial review

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Damien Combes ◽  
Romain Lancigu ◽  
Patrick Desbordes de Cepoy ◽  
Filippo Caporilli-Razza ◽  
Laurent Hubert ◽  
...  
Keyword(s):  
Joint Replacement ◽  
Shoulder Arthroplasty ◽  
Shoulder Joint ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Glenoid Component ◽  
Humeral Component ◽  
Number Of Patients ◽  
Component Loosening ◽  
Shoulder Arthroplasties

Abstract Currently, an increasing number of patients benefit from shoulder prosthesis implantation. Radiologists are therefore more often confronted with imaging examinations involving shoulder arthroplasty, whether during a dedicated examination or incidentally. Standard radiography is the first-line imaging modality in the follow-up of these implants, before the possible use of cross-sectional imaging modalities (computed tomography and magnetic resonance imaging), ultrasound, or nuclear medicine examinations. Shoulder arthroplasties are divided into three categories: reverse shoulder arthroplasty, total shoulder arthroplasty, and partial shoulder joint replacement (including humeral hemiarthroplasty and humeral head resurfacing arthroplasty). Each of these prostheses can present complications, either shared by all types of arthroplasty or specific to each. Infection, periprosthetic fractures, humeral component loosening, heterotopic ossification, implant failure, and nerve injury can affect all types of prostheses. Instability, scapular notching, and acromial fractures can be identified after reverse shoulder arthroplasty implantation. Glenoid component loosening and rotator cuff tear are specific complications of total shoulder arthroplasty. Progressive wear of the native glenoid is the only specific complication observed in partial shoulder joint replacement. Knowledge of different types of shoulder prostheses and their complications’ radiological signs is crucial for the radiologist to initiate prompt and adequate management.

scholarly journals Short-term rates of radiolucency after primary total shoulder arthroplasty using a cementless metal-backed pegged polyethylene glenoid

2018 ◽  
Vol 12 (1_suppl) ◽  
pp. 4-10
Author(s):  
Khalid Al-Hourani ◽  
James R Smith ◽  
Mark A Crowther ◽  
Partha Sarangi ◽  
Philip A McCann
Keyword(s):  
Shoulder Arthroplasty ◽  
Glenohumeral Joint ◽  
Total Shoulder Arthroplasty ◽  
Glenoid Component ◽  
Validity Of Results ◽  
Level Of Evidence ◽  
Radiolucent Lines ◽  
Single Centre Study ◽  
Cause Of Failure

Background Total shoulder arthroplasty has shown good clinical efficacy in treating primary and secondary degenerative conditions of the glenohumeral joint. Glenoid loosening, however, remains the commonest cause of failure. The purpose of this study was to investigate the rate of radiographic periprosthetic lucency associated with the use of an uncemented, pegged, metal-backed polyethylene glenoid component. Materials and methods A retrospective, single-centre study using the Epoca (Synthes, Paoli, Pennsylvania) metal-backed glenoid component. Operations were performed by two experienced consultant upper limb surgeons. Radiographs were analysed for immediate post-operative component seating and periprosthetic radiolucent lines at predefined regular post-operative intervals. Intra- and inter-observer reliability was assessed to improve validity of results. Results Mean age and follow-up was 72 (48–91) years and 2.5 years (2–5), respectively. Main indications for total shoulder arthroplasty were primary osteoarthritis, rheumatoid arthritis, revision for failed hemi-arthroplasty and acute fracture. Ninety-six per cent of components were completely seated post-operatively. Fifty-four (95%) of the 57 shoulders had no periprosthetic radiolucent lines at most recent follow-up. Complete post-operative glenoid seating was significantly associated with the absence of later periprosthetic radiolucency (p < 0.01). Conclusion This study reports low early radiolucency rates with the pegged, uncemented, metal-backed polyethylene glenoid prosthesis used. Excellent post-operative glenoid seating is associated with a significantly lower rate of radiolucency. Longer follow-up data are required to confirm these early promising results. Level of evidence: Therapeutic, level IV.

scholarly journals Anatomic Augmented Glenoid Implants for the Management of the B2 Glenoid

2019 ◽  
Vol 3 ◽  
pp. 247154921987035
Author(s):  
Lisa GM Friedman ◽  
Grant E Garrigues
Keyword(s):  
Bone Loss ◽  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Basic Science ◽  
Total Shoulder Arthroplasty ◽  
Clinical Results ◽  
Glenoid Component ◽  
Posterior Subluxation ◽  
Component Loosening ◽  
Reverse Total Shoulder

The B2 glenoid is defined by Walch et al. as a glenoid that is biconcave with posterior erosion accompanied by posterior humeral head subluxation. This creates unique challenges for the treating orthopedic surgeon. Bone loss, excessive retroversion, and posterior subluxation make anatomic shoulder arthroplasty in this setting fraught with increased complications, including instability, glenoid component loosening, and poor clinical outcomes. Many techniques have been devised to treat the arthritic shoulder with a B2 glenoid, including hemiarthroplasty, total shoulder arthroplasty using eccentric reaming, bone grafting and custom implantation, and reverse total shoulder arthroplasty. In this review, we will focus on anatomic total shoulder arthroplasty using augmented glenoid implants to treat the B2 glenoid. Indications, clinical results, and basic science analyses of augmented anatomic glenoids are also discussed.

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