Effect of Glenoid Shape on Stress in Glenoid Implants Undergoing Superior Subluxation

2008 ◽  
Author(s):  
Jihui Li ◽  
Thomas R. Gardner ◽  
William N. Levine ◽  
Louis U. Bigliani ◽  
Christopher S. Ahmad
Keyword(s):  
Range Of Motion ◽  
Contact Stress ◽  
Central Region ◽  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Articular Surface ◽  
Total Shoulder Arthroplasty ◽  
High Stress ◽  
Implant Loosening ◽  
Motion Retrieval

Today nonconforming glenohumeral implants are a common choice for total shoulder arthroplasty (TSA). Use of the conforming implant has decreased because of the “rocking-horse” effect [1], which leads to high stress and moments at the glenoid rim when the humeral head subluxes during range of motion. Retrieval studies have provided evidence that the rocking-horse effect is the major cause of implant loosening and fracture, delamination and deformation of the glenoid rim. Nonconforming glenoid implants, owing to a larger radius of the glenoid articular surface, can reduce the rocking-horse effect by improving the rim-head contact during subluxation. However, the nonconforming shape increases the contact stress and instability when the humeral head is in the central region, where motion frequently occurs [2].

Static posterior humeral head subluxation and total shoulder arthroplasty

2009 ◽  
Vol 18 (4) ◽  
pp. 505-510 ◽  
Author(s):  
Christian Gerber ◽  
John G. Costouros ◽  
Atul Sukthankar ◽  
Sandro F. Fucentese
Keyword(s):  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Total Shoulder Arthroplasty

The role of eccentric and offset humeral head variations in total shoulder arthroplasty

2013 ◽  
Vol 22 (7) ◽  
pp. 886-893 ◽  
Author(s):  
Adam Sassoon ◽  
Bradley Schoch ◽  
Peter Rhee ◽  
Cathy D. Schleck ◽  
William S. Harmsen ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Total Shoulder Arthroplasty

Postarthroscopic Humeral Head Osteonecrosis Treated With Reverse Total Shoulder Arthroplasty

Orthopedics ◽  
2013 ◽  
Vol 36 (3) ◽  
pp. e377-e380 ◽  
Author(s):  
Matthew F. Dilisio ◽  
Jeffrey S. Noble ◽  
Robert H. Bell ◽  
Curtis R. Noel
Keyword(s):  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder

scholarly journals Eccentric Reaming for B2 Glenoids: History, Preoperative Planning, Surgical Technique, and Outcome

2019 ◽  
Vol 3 ◽  
pp. ???
Author(s):  
Matthew J Smith ◽  
Christopher M Loftis ◽  
Nathan W Skelley
Keyword(s):  
Surgical Technique ◽  
Cortical Bone ◽  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Preoperative Planning ◽  
Total Shoulder Arthroplasty ◽  
Joint Line ◽  
Neutral Position ◽  
Anterior Portion ◽  
Surgical Options

Background The biconcave (B2) glenoid is characterized by preservation of the anterior portion of the native glenoid with asymmetric wear of the posterior glenoid. Surgical options for glenoid correction have evolved. The goal of shoulder arthroplasty is to place the implants in such a manner to return the humeral head to a centered position and restore the joint line to a neutral position. There is no current consensus on method of treatment and correction. Methods The current and historical literature on total shoulder arthroplasty was used to examine technique viability. Results Asymmetric remaining can be used to address up to 15° of version correction without compromise of cortical bone. It is important to have the proper presurgical planning, to understand the limitations of correction, and to have other options available to treat the biconcave glenoid.

Effect of deltoid volume on range of motion and patient-reported outcomes following reverse total shoulder arthroplasty in rotator cuff-intact and rotator cuff-deficient conditions

2020 ◽  
pp. 175857322092504
Author(s):  
Samuel G McClatchy ◽  
Griffin M Heise ◽  
William M Mihalko ◽  
Frederick M Azar ◽  
Richard A Smith ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Patient Reported Outcomes ◽  
Total Shoulder Arthroplasty ◽  
Deltoid Muscle ◽  
Reverse Total Shoulder Arthroplasty ◽  
Shoulder Range Of Motion ◽  
Patient Reported ◽  
Reverse Total Shoulder

Background Deltoid muscle function is paramount to the success of reverse total shoulder arthroplasty. The purpose of this study was to investigate the role of deltoid volume on shoulder range of motion and patient-reported outcomes following reverse total shoulder arthroplasty in rotator cuff-intact and rotator cuff-deficient conditions. Methods Retrospective review of records identified 107 patients who met inclusion criteria. The rotator cuff integrity was evaluated by two musculoskeletal-trained radiologists. Volumetric deltoid measurements were calculated from preoperative computed tomography or magnetic resonance imaging scans. Satisfactory outcomes were defined as forward elevation of at least 135°, external rotation of at least 35°, and American Shoulder and Elbow Surgeons and Single Assessment Numerical Evaluation scores of at least 70. Results Mean total deltoid muscle volume was significantly higher in patients with satisfactory forward elevation (57.8 ± 18.1 cm³) versus unsatisfactory forward elevation (48.6 ± 19.5 cm³) (p = 0.013). When separated by rotator cuff integrity, total deltoid volume was significantly higher (p = 0.030) in patients who achieved satisfactory forward elevation in the rotator cuff-deficient group but not the rotator cuff-intact group (p = 0.533). Discussion Preoperative deltoid volume directly correlated with achieving satisfactory forward elevation after reverse total shoulder arthroplasty in rotator cuff-deficient conditions and may be one factor in determining the ability to achieve satisfactory outcomes in the rotator cuff-deficient patient.

scholarly journals Radiographic humeral head restoration after total shoulder arthroplasty: does the stem make a difference?

2021 ◽  
Vol 30 (1) ◽  
pp. 51-56
Author(s):  
Ryan M. Cox ◽  
Daniel Sholder ◽  
Laura Stoll ◽  
Joseph A. Abboud ◽  
Gerald R. Williams ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Total Shoulder Arthroplasty

Anatomic total shoulder arthroplasty in rheumatoid arthritis: A systematic review

2020 ◽  
pp. 175857322095415
Author(s):  
Ahmed Haleem ◽  
Ajaykumar Shanmugaraj ◽  
Nolan S. Horner ◽  
Timothy Leroux ◽  
Moin Khan ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Constant Score ◽  
Total Shoulder Arthroplasty ◽  
Significant Heterogeneity ◽  
Tissue Quality ◽  
Patient Reported ◽  
Clinically Significant ◽  
Reverse Total Shoulder

Purpose Given the poor soft-tissue quality in rheumatoid arthritis patients, many believe that rheumatoid arthritis should be treated with reverse total shoulder arthroplasty (rTSA). The purpose of this paper is to systematically assess outcomes of anatomic total shoulder arthroplasty (aTSA) in rheumatoid arthritis to determine if aTSA remains a viable option. Methods A comprehensive literature search was conducted identifying articles relevant to aTSA in the setting of rheumatoid arthritis with intact rotator cuff. Outcomes include clinical outcomes and rates of complication and revision. Results Ten studies were included with a total of 279 shoulders with mean follow-up of 116 ± 69 months. The mean age was 68 ± 10 years. Survivorship was 97%, 97% and 89% at 5, 10 and 20 years, respectively. The overall complication rate was 9%. Radiolucency was present in 69% of patients, of which 34% were at risk of loosening at 79 months. The overall rate of revision was 8.4%. Studies generally reported clinically significant improvements in range of motion, Constant score and ASES score. Conclusion aTSA in the rheumatoid patient results in improvements in range of motion and patient-reported outcomes. Rates of complications and survivorship are generally good in this population. However, it should be noted that there is significant heterogeneity in outcome reporting amongst the literature on this topic and that many studies fail to adequately report complication and revision rates. When compared to rTSA in patients with rheumatoid arthritis, evidence suggests that aTSA is still a viable treatment option despite the shift in utilization to rTSA.

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