A STUDY OF MORPHOMETRIC ANALYSIS AND MEASUREMENT OF ANGLE OF TORSION OF THE HEAD OF HUMERUS AND SHOULDER ARTHROPLASTY

2021 ◽  
pp. 1-4
Author(s):  
Mithu Paul ◽  
Sarbani Das ◽  
Susmita Ghosh ◽  
Tridib Kumar Sett
Keyword(s):  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
West Bengal ◽  
Vertical Wall ◽  
Head Part ◽  
Glenoid Cavity ◽  
Plaster Of Paris ◽  
Medical College ◽  
Humeral Component ◽  
Humeral Torsion

Back ground: Humerus is the longest of the long bones of superior extremity.It”s head articulates with scapular glenoid cavity to form the gleno-humeral/Shoulder joint.The rounded head of Humerus is too weakly supported in the scapular glenoid cavity lined by glenoid labrum which makes it the most mobile and most unstable nd joint and so most commonly dislocated joint of the human body.Also the humeral head part is the 2 most important part of shoulder arthroplasty. Aim of the study is to make a clinical evaluation of parameters used in prosthesis design for the humeral component applied in arthroplasty of the proximal upper extremity. Methods: A total of 100 (Rt -58,Lt –42 ) dry human Humerus available in the Department of Anatomy of Calcutta National Medical College,Kolkata,West Bengal and Nilratan Sircar Medical College,Kolkata,West Bengal were taken for the study.The Humeral heads are measured in supero-inferior(SI) diameter, and antero-posterior diameter(AP), The width of Humeral head (Wdth),and angle of Humeral Torsion were measured. At the very beginning the both sided Humerus taken for the study are properly numbered using permanent marker pen.The width of the Humeral head(Wdth) is measured 1stly by pressing the head in modelling dough and when the mould is prepared,semisolid plaster of paris is lled into the mould. After drying the replica of humeral head is smoothened upto the mark of anatomical neck of humerus thus proper width can be measured. The superoinferior(SI) diameter, and antero-posterior diameter(AP) were measured by digital slide callipers by placing it directly onto the surface of consequently numbered humeral heads. The width of Humeral head (Wdth ) were measured from these replica(properly numbered) humeral heads, made of plaster of paris at the middle, the highest thickness was measured. The measurements are taken via spreading slide calipers in milimeters. For measuring the angle of humeral angle of torsion ,we xedly placed the humerus on to a area over the smooth part of the vertical wall which was meeting another horizontal wall at 90 degrees angle thus the line joining the two epicondyles of humerus lies parallel to the vertical wall.Now placing the straight edge of the protractor onto the upper end of humerus the angle of humeral torsion is measured. Results: Both sided Humerae were analysed separately for Morphological measurement, and angle of Humeral torsion.Mean values for SI were 41.31+3.46mm (Right side) and 40.91+3.27mm(Left side). Mean values for AP were 38.27+3.05mm (Right side) and 37.91+2.70mm(Left side). Conclusion: This study will contribute some relevant data and help the orthopaeditians in dealing with cases of shoulder pathology and shoulder arthroplasty cases.

scholarly journals Anatomic humeral head replacement with a press-fit prosthesis: An in vivo radiographic study

2017 ◽  
Vol 9 (3) ◽  
Author(s):  
Bryan Vopat ◽  
Jeremy Truntzer ◽  
Daniel Aaron ◽  
Jack Anavian ◽  
Joel Schwartz ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Total Shoulder Arthroplasty ◽  
Anatomic Reconstruction ◽  
Implant Design ◽  
Design Parameters ◽  
Press Fit ◽  
Humeral Component ◽  
Glenohumeral Osteoarthritis ◽  
The Mean

Successful total shoulder arthroplasty is, in part, dependent on anatomic reconstruction of the glenohumeral joint. The purpose of this study was to evaluate the post-operative anatomy of total shoulder arthroplasty with an anatomic implant design in patients with primary glenohumeral osteoarthritis and compare it to published normative anatomic measurements. Fifty-one patients (56 shoulders) with primary glenohumeral osteoarthritis were treated with a press-fit humeral component as part of a total shoulder arthroplasty (Aequalis, Tornier, Edina, Minnesota). Analysis of postoperative true anterior posterior radiographs was performed with use of a custom software algorithm. The mean humeral inclination (head-shaft angle), mean humeral implant anatomical humeral axis, mean greater tuberosity height, and mean humeral head center offset (medial offset) were 135.4±5.1°, 1.73±1.7°, 6.9±2.4 mm, and 3.8±1.8 mm, respectively. All parameters were within the ranges reported in the literature for normal shoulders except the mean humeral head center offset, which was less than reported in the literature. Anatomic parameters of a total shoulder arthroplasty can be achieved with an anatomically designed, modular adaptable press-fit design. Reduced medial humeral head center offset was likely dependent upon implant specific design parameters.

scholarly journals Determination of humeral inclination in stemless shoulder arthroplasty using plain radiographs

2019 ◽  
Vol 11 (4) ◽  
Author(s):  
Sascha Beck ◽  
Robert J. Martin ◽  
Theodor Patsalis ◽  
Manuel Burggraf ◽  
André Busch ◽  
...  
Keyword(s):  
Inclination Angle ◽  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Plain Radiograph ◽  
Plain Radiographs ◽  
Neck Shaft Angle ◽  
Mathematical Algorithm ◽  
Humeral Component ◽  
Stemless Shoulder Arthroplasty ◽  
The Impact

Plain radiographs of the shoulder are routinely used to assess implant orientation after shoulder arthroplasty. Recently, humeral inclination has come into focus especially in reverse stemless shoulder arthroplasty. But, in X-ray projections not exactly parallel to the base of the humeral component, the humeral inclination angle cannot be determined precisely. Therefore, we established a mathematical algorithm to calculate the humeral neck shaft angle and counterchecked the formula using plain radiographs of a sawbone model containing a humeral head prosthesis. With increasing angles of retroversion, the base of the humeral component forms an ellipse in plain radiographs. Knowing the width and length of the ellipse as well as the inclination angle in a plain radiograph, the exact inclination angle can be determined using the equation reported below. Thus, independent from the viewing angle or angle of retroversion, the inclination angle of a stemless humeral head implant can be estimated with an accuracy of ±1.5-degree deviation. The algorithm proposed may be the basis for further research on the impact of humeral inclination in stemless shoulder arthroplasty.

scholarly journals A morphometric study of glenoid cavity and its implication in shoulder arthroplasty and prosthetic designs

2018 ◽  
Vol 7 (04) ◽  
pp. 190-194
Author(s):  
Philip Elsy Shalom ◽  
KR Dakshayani
Keyword(s):  
Shoulder Arthroplasty ◽  
Shoulder Prosthesis ◽  
Morphometric Study ◽  
Limited Area ◽  
Glenoid Cavity ◽  
Morphological Variations ◽  
Medical College ◽  
Fixation Devices ◽  
The Mean ◽  
Variable Morphology

Abstract Background and aims: Glenoid cavity of scapula is known for its variable morphology. The variations in the shape of glenoid cavity are due to the presence of a notch in its antero-superior part. The glenoid cavity is small and allows only a limited area for fixation devices. Knowledge of its morphology and dimensions would help in designing shoulder prosthesis for shoulder arthroplasty. Aim of current study is to determine the metrical and morphological variations [variation of shapes] of the glenoid cavity of the scapula for a better understanding and management of shoulder pathology. Materials and Method: One hundred dry scapulae of unknown sex availed from the Department of Anatomy, Mysore Medical College were studied. Varying shape of glenoid cavity based on presence of notch was also noted and measurements were taken with the digital Vernier caliper. Results: The glenoid cavity was found to occur in pear, oval, inverted comma shapes in frequency of 65.3%, 28.8%, 5.7% on right side and 62.2%, 27%, 10% on left side respectively. The mean anteroposterior diameter 1 and 2 were 24.05 ± 2.79 mm and 18.31 ± 2.36mm respectively. The mean Glenoid cavity index was 68.05 ± 4.87mm. Conclusion: The findings of the present study concurs with other studies, although there is slight difference in frequency of occurrence of shape of glenoid cavity which could be explained on the basis of ethnic and racial basis. The sound knowledge of various parameters of the glenoid cavity is important while performing shoulder arthroplasty and designing glenoid prostheses

Complication and revision rates after reverse total shoulder revision from hemiarthroplasty: a systematic review

2021 ◽  
pp. 175857322110193
Author(s):  
Arjun K Reddy ◽  
Jake X Checketts ◽  
B Joshua Stephens ◽  
J Michael Anderson ◽  
Craig M Cooper ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Arthroplasty ◽  
Revisional Surgery ◽  
Total Shoulder Arthroplasty ◽  
Surgical Site Infections ◽  
Total Sample ◽  
Reverse Total Shoulder Arthroplasty ◽  
Common Complication ◽  
Humeral Component ◽  
Reverse Total Shoulder

Background Thus, the purpose of the present study was to (1) characterize common postoperative complications and (2) quantify the rates of revision in patients undergoing hemiarthroplasty to reverse total shoulder arthroplasty revisional surgery. We hypothesize that hardware loosenings will be the most common complication to occur in the sample, with the humeral component being the most common loosening. Methods This systematic review adhered to PRISMA reporting guideline. For our inclusion criteria, we included any study that contained intraoperative and/or postoperative complication data, and revision rates on patients who had undergone revision reverse total shoulder arthroplasty due to a failed hemiarthroplasty. Complications include neurologic injury, deep surgical site infections, hardware loosening/prosthetic instability, and postoperative fractures (acromion, glenoid, and humeral fractures). Results The study contained 22 studies that assessed complications from shoulders that had revision reverse total shoulder arthroplasty from a hemiarthroplasty, with a total sample of 925 shoulders. We found that the most common complication to occur was hardware loosenings (5.3%), and of the hardware loosenings, humeral loosenings (3.8%) were the most common. The revision rate was found to be 10.7%. Conclusion This systematic review found that revision reverse total shoulder arthroplasty for failed hemiarthroplasty has a high overall complication and reintervention rates, specifically for hardware loosening and revision rates.

Anatomic Total Shoulder Arthroplasty With a Stemless Humeral Component

2021 ◽  
Vol 1 (3) ◽  
pp. 263502542199712
Author(s):  
Jordan D. Walters ◽  
Stephen F. Brockmeier
Keyword(s):  
Bone Quality ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Complication Rates ◽  
Lesser Tuberosity ◽  
Critical Elements ◽  
Implant Placement ◽  
Humeral Component ◽  
Component Loosening ◽  
Deltopectoral Approach

Background: This technique video reviews anatomic total shoulder arthroplasty (TSA) with a stemless humeral component using a representative case example. Indications: Stemless TSA is indicated for patients with symptomatic glenohumeral arthritis typically younger than 65 years of age. Stemless TSA may be used for other glenohumeral degenerative conditions such as avascular necrosis or posttraumatic arthropathy, provided acceptable humeral bone quality is confirmed intraoperatively using a thumb-press test. Poor bone quality is the primary contraindication. Technique Description: Preoperatively, computed tomography is typically used for planning, and intraoperative navigation through magnetic resonance imaging is also useful. The procedure’s critical elements include beach chair positioning, standard deltopectoral approach with lesser tuberosity osteotomy (LTO), freehand proximal humeral osteotomy, perpendicular proximal humeral exposure and subsequent preparation over a central guidewire, stemless implant and humeral head sizing, perpendicular glenoid exposure and implant placement, and final humeral implantation with LTO repair/fixation. A phased rehabilitation protocol includes 6-week sling immobilization to protect the subscapularis/LTO repair and return to normal activities between 3 and 6 months postoperatively. Discussion/Conclusion: Stemless TSA shows promising early and mid-term outcomes with complication rates, including humeral loosening rates, similar to standard stemmed components. Potential complications include neurovascular injury, infection, glenoid or humeral component loosening, and rotator cuff failure.

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

A STUDY ON EXPRESSION PROFILE OF BASAL MARKER CD44 AND LUMINAL MARKER CK20 IN UROTHELIAL NEOPLASM AND ITS CORRELATION WITH WHO GRADING AND STAGING OF TUMOUR

2021 ◽  
pp. 29-32
Author(s):  
Krishnendubikas Bag ◽  
Anish kumar Rakshit ◽  
Gopinath Barui
Keyword(s):  
Urothelial Carcinoma ◽  
West Bengal ◽  
Strong Association ◽  
Lower Grade ◽  
Tumour Grade ◽  
Cross Sectional ◽  
Over Expression ◽  
Medical College ◽  
Basal Marker ◽  
Luminal Marker

Aim: Histomorphological study of urothelial carcinoma on TRBT and Cystectomy specimen and its categorization on the basis of WHO grading & pTNM staging and to nd out the correlation between CK20 and CD44 exprression with tumour grade, pTNM staging. Material And Method: This descriptive cross sectional prospective study was conducted in the Department of Pathology, R G Kar Medical College & Hospital Kolkata in collaboration with Department of Urosurgery, R G Kar Medical College & Hospital, Kolkata, West Bengal. The present study is intended to nd out over expression of CD44 & CK20 in Urothelial Carcinoma of Bladder and correlate with tumour grade and clinical features. Result: There is strong association between CD44, CK20 expression and Stage of Urothelial Carcinoma cases and had a strong association between CD44 expressions and grade Urothelial Carcinoma cases. Conclusion: CK20 overexpression was seen more signicantly in High Grade tumours HGPUC (p < 0.05) as well as advanced stage pT2 and CD44 overexpression was more signicantly in lower grade tumours LGPUC (p<0.05) as well as lower stages pT1 in urothelial carcinoma. An inverse relasionship was noted in the staining patterns of CK20 and CD44 within individual cases as well as aggregate data,with (68.24%) of tumours with CD44 loss showing CK20 positivity.

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