scholarly journals Six-Year Experience with the Delta III Reverse Shoulder Prosthesis

2009 ◽  
Vol 17 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Federico Alberto Grassi ◽  
Luigi Murena ◽  
Federico Valli ◽  
Riccardo Alberio
Keyword(s):  
Glenohumeral Joint ◽  
Functional Results ◽  
Shoulder Prosthesis ◽  
Glenoid Component ◽  
Main Concern ◽  
Massive Rotator Cuff Tear ◽  
Term Survival ◽  
Scapular Notching ◽  
Reverse Prosthesis ◽  
Humeral Component

Purpose. To report the clinical and radiographic results and complications of the Delta III reverse prosthesis. Methods. 24 women and 2 men aged 62 to 84 (mean, 75) years underwent total shoulder replacement using the Delta III reverse prosthesis. Patient diagnoses were massive rotator cuff tear (n=20), disabling sequelae of proximal humeral fractures (n=3), and failure of an unconstrained arthroplasty (n=3). Clinical and functional results were assessed using the Constant scale. Active range of motion (ROM) was measured. Scapular notching and radiolucent lines around the humeral component were evaluated using radiographs. Patient satisfaction of the treatment was evaluated by a direct interview. Results. 23 patients were followed up for 26 to 84 (mean, 42) months. Two patients had loosening of the glenoid component (at 6 months and 5 years) and underwent revision surgery. There were no instances of infection, instability, or acromial fracture. Only active elevation improved significantly after surgery, as did both the absolute and adjusted Constant scores. 12 patients were completely pain-free, 9 complained of slight pain, and one of moderate pain. The severity of scapular notching progressed with time. 15 patients were satisfied with the treatment, 6 were partially satisfied, and 2 were not satisfied. Conclusion. The Delta III prosthesis restores shoulder function but has biomechanical limits. Its use should be limited to elderly patients with severe impairment of the glenohumeral joint. Scapular notching is a main concern for the long-term survival of the implant.

Porous tantalum acetabular cups for reconstructions after peri-acetabular resections of primary bone tumours

2021 ◽  
pp. 112070002110015
Author(s):  
Riccardo Zucchini ◽  
Andrea Sambri ◽  
Claudio Giannini ◽  
Michele Fiore ◽  
Carlotta Calamelli ◽  
...  
Keyword(s):  
Bone Tumour ◽  
Hip Dislocation ◽  
Functional Results ◽  
Bone Tumours ◽  
Harris Hip Score ◽  
Porous Tantalum ◽  
Term Survival ◽  
Primary Bone ◽  
Primary Bone Tumours

Introduction: Periacetabular reconstruction after resection of primary bone tumour is a very demanding procedure. They are frequently associated with scarce functional results and a high rate of complications. We report a series of patients with periacetabular resections for primary bone tumours and reconstruction with a porous tantalum (PT) acetabular cup (AC). Materials and methods: 27 patients (median age 30 years) were included, being affected by primary bone tumours of the pelvis and treated with peri-acetabular resection and reconstruction with a PT AC. The diagnoses were 13 osteosarcomas, 7 chondrosarcomas and 7 Ewing sarcomas. Function was assessed with the Harris Hip Score and complications were classified according to Zeifang. Results: The median follow-up was 70 months. 1 patient required removal of the PT AC because of implant associated infection 55 months after surgery. There was 1 hip dislocation and no case of aseptic loosening. At final follow-up, the median HHS was 81 points (range 48–92). Conclusions: The used PT AC had good medium-term survival rates and good functional results. This technique is a viable reconstructive option after resections of periacetabular primary bone sarcomas.

Early fixation of the humeral component in stemless total shoulder arthroplasty

2022 ◽  
Vol 104-B (1) ◽  
pp. 76-82
Author(s):  
Bart ten Brinke ◽  
Brechtje Hesseling ◽  
Denise Eygendaal ◽  
Max A. Hoelen ◽  
Nina M. C. Mathijssen
Keyword(s):  
Clinical Outcomes ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Future Research ◽  
Dash Score ◽  
Term Survival ◽  
Early Migration ◽  
Humeral Component ◽  
Initial Fixation ◽  
Early Fixation

Aims Stemless humeral implants have been developed to overcome stem-related complications in total shoulder arthroplasty (TSA). However, stemless implant designs may hypothetically result in less stable initial fixation, potentially affecting long-term survival. The aim of this study is to investigate early fixation and migration patterns of the stemless humeral component of the Simpliciti Shoulder System and to evaluate clinical outcomes. Methods In this prospective cohort study, radiostereometric analysis (RSA) radiographs were obtained in 24 patients at one day, six weeks, six months, one year, and two years postoperatively. Migration was calculated using model-based RSA. Clinical outcomes were evaluated using the visual analogue scale (VAS), the Oxford Shoulder Score (OSS), the Constant-Murley Score (CMS), and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Results At two years, median translation along the x-, y-, and z-axis was -0.12 mm (interquartile range (IQR) -0.18 to 0.02), -0.17 mm (IQR -0.27 to -0.09), and 0.09 mm (IQR 0.02 to 0.31). Median rotation around the x-, y-, and z-axis was 0.12° (IQR -0.50 to 0.57), -0.98° (IQR -1.83 to 1.23), and 0.09° (IQR -0.76 to 0.30). Overall, 20 prostheses stabilized within 12 months postoperatively. Four prostheses showed continuous migration between 12 and 24 months. At two-year follow-up, with the exception of one revised prosthesis, all clinical scores improved significantly (median VAS difference at rest: -3.0 (IQR -1.5 to -6.0); OSS 22.0 (IQR 15.0 to 25.0); CMS 29.5 (IQR 15.0 to 35.75); and DASH -30.0 (IQR -20.6 to -41.67) (all p < 0.001)) with the exception of one revised prosthesis. Conclusion In conclusion, we found that 20 out of 24 implants stabilized within 12 months postoperatively. The significance of continuous migration in four implants is unclear and future research on the predictive value of early migration for future loosening in TSA is required. Clinical results revealed a clinically relevant improvement. Cite this article: Bone Joint J 2022;104-B(1):76–82.

scholarly journals The use of partial prosthesis in shoulder surgery

2016 ◽  
Vol 69 (suppl. 1) ◽  
pp. 47-51
Author(s):  
Srdjan Ninkovic ◽  
Sladjana Radosavljevic ◽  
Vladimir Harhaji ◽  
Ivica Lalic ◽  
Natasa Janjic ◽  
...  
Keyword(s):  
Orthopedic Surgery ◽  
Daily Living ◽  
Articular Surface ◽  
Functional Results ◽  
Risk Groups ◽  
Daily Activities ◽  
Shoulder Prosthesis ◽  
Clinical Center ◽  
Novi Sad ◽  
Shoulder Score

Introduction. Indications for the use of partial shoulder prosthesis are dislocated four-part fractures and multi-part and four-part fractures-dislocations, impressive fractures of the humeral head (including involvement of more than 40% of the articular surface) and ?head splitting? fractures of humerus. The aim of this study was to present the results of the application of partial shoulder prosthesis at the Department of Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina in Novi Sad and identify risk groups among the participants. Material and Methods. The study, which was retrospective, included 22 patients who had undergone the partial shoulder arthroplasty in the period from 2005 to 2015 at the Department of Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina. The functional results were evaluated on the basis of the Constant Shoulder Score. Results. The study sample consisted of 15 women and 7 men, whose mean age was 64.9 ? 9.1 years. The average time from the injury to surgery was 13.3 days. According to the Constant scoring scale, the result was excellent in 6 (27%) patients, good in 3 (14%), fair in 7 (32%), and poor in 6 (27%) participants. 75% of participants said they were satisfied with the results of the operation. Conclusion. Partial shoulder prosthesis gives good functional results and allows resumption of activities of daily living. Better results were obtained within the subjective segments (pain, daily activities, vitality), which points out a greater subjective patient?s satisfaction in relation to the measured functio?nal outcome.

Treatment of cephalotuberosity fractures in elderly patients treated by reverse shoulder prosthesis: a study of functional results in relation to deltoid tension

2019 ◽  
Vol 44 (1) ◽  
pp. 147-154 ◽  
Author(s):  
Pierre-Sylvain Marcheix ◽  
Isaline Bazin ◽  
Guillaume Vergnenegre ◽  
Christian Mabit ◽  
Jean-Louis Charissoux
Keyword(s):  
Elderly Patients ◽  
Functional Results ◽  
Shoulder Prosthesis ◽  
Reverse Shoulder Prosthesis

Redesign of a Reverse Shoulder Prosthesis: Kinematic and Mechanical Study

2014 ◽  
Vol 670-671 ◽  
pp. 847-851 ◽  
Author(s):  
Davide Tumino ◽  
Tommaso Ingrassia ◽  
Vincenzo Nigrelli ◽  
Giovan Battista Trinca
Keyword(s):  
Surgical Procedure ◽  
Laser Scanner ◽  
Shoulder Prosthesis ◽  
Solid Model ◽  
Glenoid Component ◽  
Shear Forces ◽  
Final Model ◽  
Reverse Shoulder Prosthesis ◽  
Mechanical Study ◽  
The Common

In this work a commercial reverse shoulder prosthesis has been redesigned to improve performances in terms of range of movements of the implant and stability to dislocation. A kinematic and mechanic study has been performed using a realistic solid model of the prothesised shoulder: in particular, all the components of the prosthesis have been acquired via a 3D laser scanner and inserted in a virtual humerus-glenoid system by reproducing the common surgical procedure. The final model has been used to measure the maximum angles of abduction and rotation of the arm and the shear forces that cause dislocation. Modifications proposed to the commercial prosthesis are: a different orientation of the cutting plane of the glenoid component and the interposition of a spacer to move the center of rotation of the arm.

Glenosphere design affects range of movement and risk of friction-type scapular impingement in reverse shoulder arthroplasty

2018 ◽  
Vol 100-B (9) ◽  
pp. 1182-1186 ◽  
Author(s):  
B. S. Werner ◽  
J. Chaoui ◽  
G. Walch
Keyword(s):  
Internal Rotation ◽  
Shoulder Arthroplasty ◽  
External Rotation ◽  
Reverse Shoulder Arthroplasty ◽  
Large Diameter ◽  
Glenoid Component ◽  
Range Of Movement ◽  
Scapular Notching ◽  
Component Size ◽  
Centre Of Rotation

Aims Scapular notching is a frequently observed radiographic phenomenon in reverse shoulder arthroplasty (RSA), signifying impingement of components. The purposes of this study were to evaluate the effect of glenoid component size and glenosphere type on impingement-free range of movement (ROM) for extension and internal and external rotation in a virtual RSA model, and to determine the optimal configuration to reduce the incidence of friction-type scapular notching. Materials and Methods Preoperative CT scans obtained in 21 patients (three male, 18 female) with primary osteoarthritis were analyzed using modelling software. Two concurrent factors were tested for impingement-free ROM and translation of the centre of rotation: glenosphere diameter (36 mm vs 39 mm) and type (centred, 2 mm inferior eccentric offset, 10° inferior tilt). Results Glenosphere size was most predictive of increased extension and external rotation, whereas lateralization of the centre of rotation was the most predictive factor for internal rotation. A larger diameter of glenosphere combined with a 10° tilted configuration demonstrated superior values for extension and external rotation, whereas the eccentric component improved internal rotation by a mean 8.9° (standard deviation 2.7°) compared with a standard concentric glenosphere. Conclusion Glenosphere configuration can be modified to increase range of movement in RSA. Friction-type scapular notching was most effectively reduced by use of a large-diameter glenosphere with 10° inferior tilt. Cite this article: Bone Joint J 2018;100-B:1182–6.

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.

Effect of Implant Shape and Material Properties on Stresses in the Glenoid Components of Total Shoulder Arthroplasties: A Finite Element Analysis

2010 ◽  
Author(s):  
Jingzhou Zhang ◽  
Charlie Yongpravat ◽  
Marc D. Dyrszka ◽  
William N. Levine ◽  
Thomas R. Gardner ◽  
...  
Keyword(s):  
Humeral Head ◽  
Glenohumeral Joint ◽  
Total Shoulder Arthroplasty ◽  
Peak Stress ◽  
Glenoid Component ◽  
Joint Stability ◽  
Element Analysis ◽  
Total Shoulder Arthroplasties ◽  
Shoulder Arthroplasties ◽  
Glenoid Loosening

The geometry of the glenohumeral joint is osseous, naturally nonconforming and minimally constrained, thus the essential requirement of a glenohumeral prosthesis in total shoulder arthroplasty (TSA) is prevention of joint degeneration and glenoid loosening. A variety of glenoid prostheses have been developed. Nonconforming glenohumeral implants are common for TSA. However, the nonconforming shape increases the instability when the humeral head is in the central region, where motion frequently occurs. Conforming implants can increase joint stability, but the “rocking-horse” effect [1] caused by the conforming shape is thought to lead to high stresses and moments at the glenoid rim when the humeral head approaches the periphery during its range of motion. The hybrid design, with a conforming center and a nonconforming periphery, combines the advantages of both nonconforming and conforming implant geometries. It has been shown [2] that the peak stress generated in glenoid components during activities of daily living can be as high as 25 MPa, which exceeds the polyethylene yield strength of the glenoid component and can lead to wear and cold flow of the component. Polyethylene has also been shown to be viscoelastic [3]. Therefore, both elastic-plastic and viscoelastic-plastic models of the glenoid implant were used to determine how viscoelasticity affected stress in the implant. The effects of implant shape on the stresses in the center, transition, and superior zones for the three different glenoid implant shapes, as well as on the stress in the underlying cement and bone, were determined in this study.

scholarly journals The influence of glenoid component position on scapular notching: a detailed radiographic analysis at midterm follow-up

2020 ◽  
Vol 4 (1) ◽  
pp. 144-150 ◽  
Author(s):  
Nicholas C. Duethman ◽  
William R. Aibinder ◽  
Ngoc Tram V. Nguyen ◽  
Joaquin Sanchez-Sotelo
Keyword(s):  
Glenoid Component ◽  
Radiographic Analysis ◽  
Component Position ◽  
Scapular Notching

Extended ray resection for sarcoma of the hand: long-term survival and functional results

2019 ◽  
Vol 45 (2) ◽  
pp. 160-166 ◽  
Author(s):  
Farhad Farzaliyev ◽  
Hans-Ulrich Steinau ◽  
Halil-Ibrahim Karadag ◽  
Alexander Touma ◽  
Lars Erik Podleska
Keyword(s):  
Soft Tissue ◽  
Survival Rates ◽  
Soft Tissue Sarcomas ◽  
Functional Results ◽  
Contralateral Side ◽  
Level Of Evidence ◽  
Term Survival ◽  
Kaplan Meier

In this retrospective study, we analysed the long-term oncological and functional results after extended ray resection for sarcoma of the hand. Recurrence-free and overall survivals were calculated using the Kaplan–Meier method. The function of the operated hand was assessed with the Michigan Hand Questionnaire and compared with the contralateral side. Extended ray resection was performed in 25 out of 168 consecutive patients with soft-tissue and bony sarcomas of the hand. The overall 5- and 10-year, disease-specific survival rates were 86% and 81%, respectively. Local recurrences were observed in two patients. The Michigan Hand Questionnaire score for the affected hand at follow-up in nine patients was 82 points versus 95 for the healthy contralateral hands. We conclude that extended ray resection of osseous sarcomas breaking through the bone into the soft tissue or for soft tissue sarcomas invading bone is a preferable alternative to hand ablation when excision can be achieved with tumour-free margins. Level of evidence: III

Sign in / Sign up

Export Citation Format

Share Document