Glenohumeral joint reconstruction using statistical shape modeling

Huang, Yichen; Robinson, Dale L.; Pitocchi, Jonathan; Lee, Peter Vee Sin; Ackland, David C.

doi:10.1007/s10237-021-01533-6

Cited by 11 publications

(6 citation statements)

References 39 publications

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“…Our findings are based on a shoulder model of the VHM, with the anatomy and joint loading conditions representative of those of a 50th percentile man (see the Appendix, available online). To assess the generalizability of our findings across the population, we employed a previous statistical shape model of the upper limb 35 and reran simulations with the anatomy of a 5th, 32nd, 50th, 68th, and 95th percentile man (see the Appendix, available online). With the exception of some isolated discrepancies, particularly at the extreme ranges of shoulder anatomy (5th and 95th percentiles), these results showed that our overall trends in glenoid, humeral, and graft contact for the nominal shoulder model were similar to those of different shoulder geometries spanning the population, for instance, in maximum graft contact pressure, maximum glenoid cartilage contact pressure, and maximum humeral cartilage contact pressure with and without graft perturbation.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Glenoid Bone Loss and Graft Positioning on Graft and Cartilage Contact Pressures After the Latarjet Procedure

et al. 2023

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Background: Glenohumeral joint contact loading before and after glenoid bone grafting for recurrent anterior instability remains poorly understood. Purpose: To develop a computational model to evaluate the influence of glenoid bone loss and graft positioning on graft and cartilage contact pressures after the Latarjet procedure. Study Design: Controlled laboratory study. Methods: A finite element model of the shoulder was developed using kinematics, muscle and glenohumeral joint loading of 6 male participants. Muscle and joint forces at 90° of abduction and external rotation were calculated and employed in simulations of the native shoulder, as well as the shoulder with a Bankart lesion, 10% and 25% glenoid bone loss, and after the Latarjet procedure. Results: A Bankart lesion as well as glenoid bone loss of 10% and 25% significantly increased glenoid and humeral cartilage contact pressures compared with the native shoulder ( P < .05). The Latarjet procedure did not significantly increase glenoid cartilage contact pressure. With 25% glenoid bone loss, the Latarjet procedure with a graft flush with the glenoid and the humerus positioned at the glenoid half-width resulted in significantly increased humeral cartilage contact pressure compared with that preoperatively ( P = .023). Under the same condition, medializing the graft by 1 mm resulted in humeral cartilage contact pressure comparable with that preoperatively ( P = .097). Graft lateralization by 1 mm resulted in significantly increased humeral cartilage contact pressure in both glenoid bone loss conditions ( P < .05). Conclusion: This modeling study showed that labral damage and greater glenoid bone loss significantly increased glenoid and humeral cartilage contact pressures in the shoulder. The Latarjet procedure may mitigate this to an extent, although glenoid and humeral contact loading was sensitive to graft placement. Clinical Relevance: The Latarjet procedure with a correctly positioned graft should not lead to increased glenohumeral joint contact loading. The present study suggests that lateral graft overhang should be avoided, and in the situation of large glenoid bone defects, slight medialization (ie, 1 mm) of the graft may help to mitigate glenohumeral joint contact overloading.

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Section: Discussionmentioning

confidence: 99%

The Influence of Glenoid Bone Loss and Graft Positioning on Graft and Cartilage Contact Pressures After the Latarjet Procedure

et al. 2023

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“…Moreover, a classification system based on proximal humeral anatomy might impact on the development of implant designs in the future. Recently, statistical 3 D shape modelling has been used to obtain a more precise analysis of different anatomical variations and glenohumeral joint reconstruction [8,9,10,11]. Casier et al found different scapular variants using a statistical 3D shape modelling approach.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, Huang et al introduced shape prediction models to obtain complete scapular and humeral geometry prediction based on seven or fewer morphometric measurements [10]. Despite the extreme interest in this system, it is currently difficult to use in clinical practice and study protocols due to its difficult reproducibility [9]. We hypothesized that the geometry of the proximal humerus could be a predisposing factor for aseptic loosening of stemmed implants in shoulder arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

A Novel Radiological Classification System of the Proximal Humerus

Sangaletti,

Abuljadail,

Akkaya

et al. 2023

Z Orthop Unfall

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Different anatomical variants have been reported for the proximal and distal femur. Given this context, the goal of our study was to answer the following question: Can we also identify different anatomical variants of the proximal humerus?Two hundred anteroposterior (AP) radiographs of the proximal humerus with an equal gender distribution and equal laterality per gender were reviewed. The metaphyseal diameter of the proximal humerus at the level of the anatomical neck (X) and the intramedullary diameter at 10 cm from the apex of the greater tuberosity (Y) were measured. A new ratio was established, based on both measurements (Y/X). Radiographs showed different anatomical variants: type A: Y/X < 0.3, type B: Y/X = 0.3–0.4, type C: Y/X > 0.4. Two observers reviewed the AP radiographs independently and blindly in 2 different sessions.Three different anatomical groups (A, B and C) were identified based on the 25th and 75th percentiles. A higher percentage of type C was observed among females and a higher percentage of type A among males. A high inter-observer reliability was noted, with a Cronbach’s alpha of 0.97 (ICC 0.96–0.98). The intra-observer reliability for observer 1 had a Cronbach’s alpha of 0.98.A novel radiological classification of the proximal humerus has been established based on 3 different anatomical types (A, B and C). Further studies are needed to establish whether the novel classification system can be used as an indicator for aseptic loosening of cemented or cementless total shoulder arthroplasty.

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“…SSMs have been used to describe shape variation in the bones of the upper extremities. 19 , 20 , 21 , 22 To our knowledge, however, no studies have used SSMs to analyze 3D morphology and the shape variations of the distal humerus. Therefore, the aims of this study were: (i) to develop SSMs of the distal humerus based on Chinese data to systematically explore the major variations in this bone; (ii) to evaluate the 3D morphology of the distal humerus in healthy elbows; and (iii) to further investigate the proper morphology differences among the articular components by measuring differences in the surfaces in each shape variation.…”

Section: Introductionmentioning

confidence: 99%

“…It can systematically describe the statistical variations of the anatomic shape and identify relationships between various anatomic features. SSMs have been used to describe shape variation in the bones of the upper extremities 19–22 . To our knowledge, however, no studies have used SSMs to analyze 3D morphology and the shape variations of the distal humerus.…”

Section: Introductionmentioning

confidence: 99%

Distal Humerus Morphological Analysis of Chinese Individuals: A Statistical Shape Modeling Approach

Wang

Guo

et al. 2022

Orthopaedic Surgery

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Objective: A detailed analysis of the morphology of distal humeral articulation can help in the creation of anatomic prostheses of hemiarthroplasty. This study used statistical shape modeling to evaluate the 3D morphology of the distal humerus in healthy Chinese individuals and to investigate the proper articular morphology differences.Methods: A statistical shape model (SSM) of the distal humerus was created using CT scans of 106 survey-confirmed nonpathologic elbows. In addition, the articular components of each principal component (PC) were selected and fitted on the mean mode. The Euclidean point-to-mesh distance of articular modes was calculated as a measurement the proper change in the morphology of the articulation. Results:The first seven PCs jointly accounted for 80.9% of the total variation (44.4%, 12.2%, 7.9%, 5.9%, 4.1%, 3.4% and 3%, respectively). In the mean model, the distance between the medial and lateral epicondyles was 57.4 mm, the width of the articulation was 42.1 mm, and the angle of the transepicondylar line (TEL) and C line was 4.8 . The articular surface differences of the first PC were significant (RMS: 1.43 mm in the À3 SD model and 2.38 mm in the +3 SD model), whereas under other conditions, the differences were not remarkable despite the maximum deformation not exceeding 1 mm. Conclusion:A novel method (SSM) was used to evaluate the 3D morphology of the distal humerus in healthy Chinese individuals and investigate the proper articular shape differences. We found the proper shape of articular surface basically transformed into one variation pattern which was relevant to the bone size, even though the morphology of distal humerus possessed complicated variation modes. The findings of this study can be helpful to design the next generation of elbow hemiarthroplasty in the future.

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Glenohumeral joint reconstruction using statistical shape modeling

Cited by 11 publications

References 39 publications

The Influence of Glenoid Bone Loss and Graft Positioning on Graft and Cartilage Contact Pressures After the Latarjet Procedure

The Influence of Glenoid Bone Loss and Graft Positioning on Graft and Cartilage Contact Pressures After the Latarjet Procedure

A Novel Radiological Classification System of the Proximal Humerus

Distal Humerus Morphological Analysis of Chinese Individuals: A Statistical Shape Modeling Approach

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