A stochastic analysis of glenoid inclination angle and superior migration of the humeral head

Flieg, Nicholas G.; Gatti, Christopher J.; Doro, Lisa Case; Langenderfer, Joseph E.; Carpenter, James E.; Hughes, R.

doi:10.1016/j.clinbiomech.2008.01.001

Cited by 30 publications

(25 citation statements)

References 29 publications

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“…9 Conversely, the upward inclination of the glenoid has been associated with an increase of the upward migration humeral head in a cadaveric study 25 and in a numeric study. 5 In addition, an experimental study that tested cyclic loading on glenoid components cemented on artificial bone reported an improved glenoid fixation with a downward inclination of the glenoid. 14 According to these studies, the downward inclination of the glenoid component should be advantageous for glenohumeral joint stability when muscles of the rotator cuff are deficient.…”

mentioning

confidence: 99%

Total shoulder arthroplasty: Downward inclination of the glenoid component to balance supraspinatus deficiency

Terrier

Merlini

Pioletti

et al. 2009

Journal of Shoulder and Elbow Surgery

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Hypothesis: Supraspinatus deficiency associated with total shoulder arthroplasty (TSA) provokes eccentric loading and may induce loosening of the glenoid component. A downward inclination of the glenoid component has been proposed to balance supraspinatus deficiency. Methods: This hypothesis was assessed by a numeric musculoskeletal model of the glenohumeral joint during active abduction. Three cases were compared: TSA with normal muscular function, TSA with supraspinatus deficiency, and TSA with supraspinatus deficiency and downward inclination of the glenoid. Results: Supraspinatus deficiency increased humeral migration and eccentric loading. A downward inclination of the glenoid partly balanced the loss of stability, but this potential advantage was counterbalanced by an important stress increase within the glenoid cement. The additional subchondral bone reaming required to incline the glenoid component indeed reduced the bone support, increasing cement deformation and stress. Conclusion: Glenoid inclination should not be obtained at the expense of subchondral bone support. Level of evidence: Basic science study.

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mentioning

confidence: 99%

Total shoulder arthroplasty: Downward inclination of the glenoid component to balance supraspinatus deficiency

Terrier

Merlini

Pioletti

et al. 2009

Journal of Shoulder and Elbow Surgery

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“…[1][2][3] When planning a total shoulder replacement (TSR), it is essential to address the morphology of any erosion of the glenoid in order to improve implant survival. [4][5][6][7][8][9] Optimal implant shape and positioning can be difficult to achieve, especially when bony support is lacking. 10 The positioning of the glenoid component requires a precise understanding of the orientation of the glenoid surface relative to the scapula.…”

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confidence: 99%

Measurements of three-dimensional glenoid erosion when planning the prosthetic replacement of osteoarthritic shoulders

Terrier

Ston

Larrea

et al. 2014

The Bone & Joint Journal

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The three-dimensional (3D) correction of glenoid erosion is critical to the long-term success of total shoulder replacement (TSR). In order to characterise the 3D morphology of eroded glenoid surfaces, we looked for a set of morphological parameters useful for TSR planning. We defined a scapular coordinates system based on non-eroded bony landmarks. The maximum glenoid version was measured and specified in 3D by its orientation angle. Medialisation was considered relative to the spino-glenoid notch. We analysed regular CT scans of 19 normal (N) and 86 osteoarthritic (OA) scapulae. When the maximum version of OA shoulders was higher than 10°, the orientation was not only posterior, but extended in postero-superior (35%), postero-inferior (6%) and anterior sectors (4%). The medialisation of the glenoid was higher in OA than normal shoulders. The orientation angle of maximum version appeared as a critical parameter to specify the glenoid shape in 3D. It will be very useful in planning the best position for the glenoid in TSR. Osteoarthritis (OA) of the gleno-humeral joint is often associated with an erosion of the glenoid.

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“…In a lowerlimb musculoskeletal model developed by McLean et al [76], Monte Carlo perturbations on activation levels in the quadriceps and hamstrings and initial contact conditions were used to evaluate threedimensional loading at the knee. Compared to proposed injury mechanisms associated with sagittal plane forces, the predicted distribution of joint loading never exceeded the level expected for an ACL tear [77].…”

Section: Musculoskeletal Modellingmentioning

confidence: 99%

“…Flieg et al [77] performed a Monte Carlo simulation on a musculoskeletal model of the glenohumeral joint with uncertainty in muscle forces to compute the likelihood that the glenohumeral net reaction force would be directed to promote superior humeral head migration. Moving away from a single average musculoskeletal model, Langenderfer et al accounted for subject variability with distributions characterizing musculoskeletal architecture and moment arm and showed that the probabilistic predictions of glenohumeral strength for healthy normal and subjects with rotator cuff tears explained the variability in measured values [78].…”

Section: Musculoskeletal Modellingmentioning

confidence: 99%

A review of probabilistic analysis in orthopaedic biomechanics

Laz

Browne

2010

Proc Inst Mech Eng H

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Probabilistic analysis methods are being increasingly applied in the orthopaedics and biomechanics literature to account for uncertainty and variability in subject geometries, properties of various structures, kinematics and joint loading, as well as uncertainty in implant alignment. As a complement to experiments, finite element modelling, and statistical analysis, probabilistic analysis provides a method of characterizing the potential impact of variability in parameters on performance. This paper presents an overview of probabilistic analysis and a review of biomechanics literature utilizing probabilistic methods in structural reliability, kinematics, joint mechanics, musculoskeletal modelling, and patient-specific representations. The aim of this review paper is to demonstrate the wide range of applications of probabilistic methods and to aid researchers and clinicians in better understanding probabilistic analyses.

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A stochastic analysis of glenoid inclination angle and superior migration of the humeral head

Abstract: The results support the theory that glenoid inclination may be a risk factor for rotator cuff pathology.

Cited by 30 publications

References 29 publications

Total shoulder arthroplasty: Downward inclination of the glenoid component to balance supraspinatus deficiency

Total shoulder arthroplasty: Downward inclination of the glenoid component to balance supraspinatus deficiency

Measurements of three-dimensional glenoid erosion when planning the prosthetic replacement of osteoarthritic shoulders

A review of probabilistic analysis in orthopaedic biomechanics

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