Glenohumeral mechanics: A study of articular geometry, contact, and kinematics

Kelkar, Rajeev; Wang, Vincent; Flatow, Evan L.; Newton, Peter M.; Ateshian, Gerard A.; Bigliani, Louis U.; Pawluk, Robert J.; Mow, Van C.

doi:10.1067/mse.2001.111959

Cited by 140 publications

(94 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The reported values of humerus translation, muscle moment arms, and joint forces are consistent with the literature (Graichen et al, 2000;Hughes et al, 1998;Kelkar et al, 2001;Liu et al, 1997;Massimini et al, 2008;Poppen and Walker, 1978;Westerhoff et al, 2009). Using a 2D (axisymmetric) model of the glenoid component, Swieszkowski et al also reported that increasing glenoid thickness reduces the maximal contact pressure (Swieszkowski et al, 2003).…”

Section: Discusionsupporting

confidence: 84%

Importance of polyethylene thickness in total shoulder arthroplasty: A finite element analysis

Terrier

Brighenti

Pioletti

et al. 2012

Clinical Biomechanics

View full text Add to dashboard Cite

Background: Articular surfaces reconstruction is essential in total shoulder arthroplasty. Because of the limited glenoid bone support, thin glenoid component could improve anatomical reconstruction, but adverse mechanical effects might appear. Methods: With a numerical musculoskeletal shoulder model, we analysed and compared three values of thickness of a typical all-polyethylene glenoid component: 2, 4 (reference) and 6 mm. A loaded movement of abduction in the scapular plane was simulated. We evaluated the humeral head translation, the muscle moment arms, the joint force, the articular contact pattern, and the polyethylene and cement stress. Findings Decreasing polyethylene thickness from 6 to 2 mm slightly increased humeral head translation and muscle moment arms. This induced a small decreased of the joint reaction force, but important increase of stress within the polyethylene and the cement mantel. Interpretation The reference thickness of 4 mm seems a good compromise to avoid stress concentration and joint stuffing.

show abstract

Section: Discusionsupporting

confidence: 84%

Importance of polyethylene thickness in total shoulder arthroplasty: A finite element analysis

Terrier

Brighenti

Pioletti

et al. 2012

Clinical Biomechanics

View full text Add to dashboard Cite

show abstract

“…A complex combination of static and dynamic stabilizers about the glenohumeral joint balances this inherent mobility with functional stability. A great deal of the dynamic restraint of the glenohumeral joint arises from the concavity-compression mechanism created by the rotator cuff [15,18]. This mechanism stabilizes the shoulder at middle range of motion (ROM) when the capsulolabral structures are lax and at terminal ROM through muscle activity that limits motion and decreases strain on the glenohumeral ligaments [6,16,21,27].…”

Section: Introductionmentioning

confidence: 99%

Rotator Cuff Tear and Glenohumeral Instability

Gomberawalla

Sekiya

2014

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background The rotator cuff plays a significant role in the static and dynamic stability of the glenohumeral joint. Rotator cuff tears may occur after shoulder dislocations, whether in younger athletes or older patients with agerelated tendon degeneration. Untreated tears may cause persistent pain, dysfunction, instability, and degenerative changes. A thorough understanding of when to look for rotator cuff tears after shoulder dislocations and how best to manage them may decrease patients' pain and improve function. Questions/purposes We systematically reviewed the available literature to better understand (1) when a rotator cuff tear should be suspected after a dislocation, (2) whether surgical or nonsurgical approaches result in better scores for pain and satisfaction in patients with rotator cuff tears resulting from shoulder dislocations, and (3) whether intraarticular lesions, rotator cuff tears, or both should be addressed when surgery is performed. Methods We systematically searched MEDLINE 1 , CI-NAHL, and EMBASE for studies published from 1950 to 2012. We included studies reporting outcomes after treatment in patients with rotator cuff tears and shoulder dislocations. We excluded case reports, studies without any treatment, and studies about patients treated with arthroplasty. Five Level III and six Level IV studies were ultimately selected for review. Results Patients with persistent pain or dysfunction after a shoulder dislocation often had a concomitant rotator cuff tear. Surgical repair resulted in improved pain relief and patient satisfaction compared to nonoperative management. Repair of the rotator cuff, along with concomitant capsulolabral lesions, helped restore shoulder stability. While these findings are based on Level III and IV evidence, better long-term studies with larger cohorts are needed to strengthen evidence-based recommendations. Conclusions Persistent pain and dysfunction after a shoulder dislocation should prompt evaluation of the rotator cuff, especially in contact or overhead athletes, patients older than 40 years, or those with nerve injury. Surgery should be considered in the appropriately active patient with a rotator cuff tear after dislocation. While the current literature suggests improved stability and function after surgical repair of the rotator cuff, higher-quality prospective studies are necessary to make definitive conclusions.

show abstract

“…A first circle was fitted to the glenoid bone, resulting in a radius of 30 mm. The second circle, representing the articular side, was chosen to have a radius 2 mm greater than radius of the humeral head [6,7], and was positioned to set the cartilage thickness in the middle of the glenoid at 2 mm [6]. These two circles were then limited in the superior and inferior part by two radius lines, forming an angle of 66 degrees [16].…”

Section: Methodsmentioning

confidence: 99%

“…Using open MRI on healthy volunteers, Graichen et al [10] observed an average downward translation of 1 mm after the initial upward translation, and a centering of the joint between 90 and 120 degrees of abduction. In a cadaver study [7], the upward and downward translation of the humerus during shoulder abduction was clearly observed, in a range of about 2 mm.…”

Section: Introductionmentioning

confidence: 94%

See 1 more Smart Citation

An algorithm to allow humerus translation in the indeterminate problem of shoulder abduction

Terrier

Vogel

Capezzali

et al. 2008

Medical Engineering & Physics

View full text Add to dashboard Cite

The shoulder is one of the most complex joints of the human body, mainly because of its large range of motion, but also because of its active muscular stabilisation. Actually, the numerous stabilizing muscles and degrees of freedom yield indeterminate biomechanical models. To solve this indeterminate, most models use reverse dynamics with a simplified ball-socket joint, preventing therefore the natural humerus translation. In this paper, an algorithm was specifically developed to solve the indeterminate problem by a feedback control of muscle activation, allowing the natural humerus translation. Abduction was considered in the scapular plane, accounting for the three deltoid parts and the rotator cuff muscles. The major aim of this study was to validate the numerical algorithm, which was here restricted to two-dimensions in order to compare the numerical solution to a known algebraic one. This comparison gave a relative error below 0.1%. The joint reaction force was comparable to other models and the humerus translation was in agreement with in vivo or in vitro studies.

show abstract

Glenohumeral mechanics: A study of articular geometry, contact, and kinematics

Cited by 140 publications

References 29 publications

Importance of polyethylene thickness in total shoulder arthroplasty: A finite element analysis

Importance of polyethylene thickness in total shoulder arthroplasty: A finite element analysis

Rotator Cuff Tear and Glenohumeral Instability

An algorithm to allow humerus translation in the indeterminate problem of shoulder abduction

Contact Info

Product

Resources

About