The effect of glenohumeral radial mismatch on different augmented total shoulder arthroplasty glenoid designs: a finite element analysis

Sabesan, Vani J.; Lima, Diego J.L.; Whaley, James; Pathak, Varun; Zhang, Liying

doi:10.1016/j.jse.2018.11.059

Cited by 11 publications

(12 citation statements)

References 33 publications

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“…Biomechanical studies have shown that the wedge-shaped glenoid component has a better performance and fixation profile with lower overall micromotion and stress levels on the implant compared with the stepped-type component. 17 , 18 One retrospective case series described the efficacy of the stepped glenoid component for treating the anterior glenoid bone loss. 10 However, the wedge-shaped glenoid component would be more suitable than the stepped component from a biomechanical perspective.…”

Section: Discussionmentioning

confidence: 99%

Total shoulder arthroplasty with an anteriorly augmented glenoid component for glenohumeral osteoarthritis with anterior glenoid bone loss: a case report

2021

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Section: Discussionmentioning

confidence: 99%

Total shoulder arthroplasty with an anteriorly augmented glenoid component for glenohumeral osteoarthritis with anterior glenoid bone loss: a case report

2021

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“…Statistical significance was set at P < .05. Our sample size was determined by an a priori power analysis based on a prior biomechanical study 15 that compared glenoid compression and translation with varying amounts of glenohumeral mismatch. The power analysis indicated that 8 samples were needed for each testing condition to detect a statistically significant difference in humeral head position at the P ¼ .05 level with a power of 0.8.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical comparison of zoned-conformity glenoid versus standard glenoid in total shoulder arthroplasty: impact on rotator cuff strain and glenohumeral translation

Wright

Abbasi

Murthi

2021

Journal of Shoulder and Elbow Surgery

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Background: Current standard total shoulder arthroplasty glenoid implants allow for high levels of glenohumeral mismatch and associated high levels of humeral head translation to improve range of motion and reduce rim stresses on the glenoid. However, high levels of glenohumeral mismatch could also increase glenoid edge loading, eccentric wear, and rotator cuff strain. A zoned-conformity glenoid may be able to reduce the forces on the rotator cuff and glenoid. We compared rotator cuff strain and glenohumeral translation between a standard glenoid (SG) with moderate glenohumeral mismatch and a zoned-conformity glenoid (conforming glenoid [CG]) that limits mismatch. We hypothesized that the CG would have lower levels of strain on the rotator cuff and lower levels of humeral head translation compared with the SG. Methods: Eight fresh frozen cadaveric shoulders, aged 72 years (range, 67-76 years), were used in this biomechanical study. The specimens were first tested in the intact state. We cycled them 3 times from 0 to 60 of abduction and measured the superiorly-inferiorly and anteriorly-posteriorly directed forces at the joint, compressive forces applied to the glenoid, and humeral head translation. The specimens were then implanted with a standard press-fit humeral component and a polyethylene glenoid with 3 peripherally cemented pegs and a central press-fit peg. Testing was repeated. Finally, the SG was removed, the CG was implanted, and each specimen was tested a third time. Results: The average superiorly directed force at the glenohumeral joint was significantly lower in the intact and CG groups (18.1 AE 18.6 N and 19.8 AE 16.2 N, respectively) than in the SG group (29.3 AE 21.9 N, P ¼ .024). The maximum force directed against the glenoid was also significantly lower in the CG group (87.6 AE 11.7 N) than in the SG (96.0 AE 7.3 N) and intact (98.9 AE 16.5 N) groups (P ¼ .035). No difference was observed in humeral head translation in the anterior-posterior plane from 0 to 60 of abduction (P ¼ .998) or in the superior-inferior plane (P ¼ .999). Conclusion:A zoned-conformity glenoid was associated with similar humeral head translation but significantly lower superior forces against the rotator cuff and a significantly lower maximum force against the glenoid compared with an SG implant. These biomechanical findings suggest that a zoned-conformity implant warrants further study in the effort to maintain humeral head translation while reducing rotator cuff and glenoid forces for successful outcomes of total shoulder arthroplasty.

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“…However, poor agreement within the current study highlights that further work is still required for experimental validation of these BCs. To generate the force-driven BCs, the surfaces between the pegged platen and trabecular bone were tied, which is a common modelling approach used in shoulder implant FEMs 1 , 4 , 35 ; however, this may be an oversimplifying assumption that led to the observed poor agreement. While recent work has demonstrated the sensitivity that BCs have on whole-bone stiffness predictions of the femur, 33 similar work has not investigated the dependence of localized strains on the BCs modelled for bone–implant constructs specifically for the shoulder.…”

Section: Discussionmentioning

confidence: 99%

The Application of Digital Volume Correlation (DVC) to Evaluate Strain Predictions Generated by Finite Element Models of the Osteoarthritic Humeral Head

et al. 2020

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Continuum-level finite element models (FEMs) of the humerus offer the ability to evaluate joint replacement designs preclinically; however, experimental validation of these models is critical to ensure accuracy. The objective of the current study was to quantify experimental full-field strain magnitudes within osteoarthritic (OA) humeral heads by combining mechanical loading with volumetric microCT imaging and digital volume correlation (DVC). The experimental data was used to evaluate the accuracy of corresponding FEMs. Six OA humeral head osteotomies were harvested from patients being treated with total shoulder arthroplasty and mechanical testing was performed within a microCT scanner. MicroCT images (33.5 lm isotropic voxels) were obtained in a pre-and post-loaded state and BoneDVC was used to quantify full-field experimental strains (% 1 mm nodal spacing, accuracy = 351 lstrain, precision = 518 lstrain). Continuum-level FEMs with two types of boundary conditions (BCs) were simulated: DVC-driven and force-driven. Accuracy of the FEMs was found to be sensitive to the BC simulated with better agreement found with the use of DVC-driven BCs (slope = 0.83, r 2 = 0.80) compared to force-driven BCs (slope = 0.22, r 2 = 0.12). This study quantified mechanical strain distributions within OA trabecular bone and demonstrated the importance of BCs to ensure the accuracy of predictions generated by corresponding FEMs.

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The effect of glenohumeral radial mismatch on different augmented total shoulder arthroplasty glenoid designs: a finite element analysis

Cited by 11 publications

References 33 publications

Total shoulder arthroplasty with an anteriorly augmented glenoid component for glenohumeral osteoarthritis with anterior glenoid bone loss: a case report

Total shoulder arthroplasty with an anteriorly augmented glenoid component for glenohumeral osteoarthritis with anterior glenoid bone loss: a case report

Biomechanical comparison of zoned-conformity glenoid versus standard glenoid in total shoulder arthroplasty: impact on rotator cuff strain and glenohumeral translation

The Application of Digital Volume Correlation (DVC) to Evaluate Strain Predictions Generated by Finite Element Models of the Osteoarthritic Humeral Head

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