The shoulder is the most mobile joint of the human body, but it is very fragile; several pathologies, and especially muscular degenerations in the elderly, can affect its stability. These are more commonly called rotator cuff fractures. In the case of this type of pathology, the mobility of the shoulder decreases and pain appears. In order to restore mobility and reduce pain, implantation of an inverted shoulder prosthesis is recommended. Unfortunately, over time a notch phenomenon has been observed. In the lower position of the arm, part of the implant comes into contact with the scapula and therefore causes deterioration of the bone. Among the solutions adopted is the lateralized method with bone grafting. However, a main disadvantage of this method concerns the reconstruction of the graft in the case of prosthesis revision. In this context, the aim of the present work was to reconstruct the shoulder joint in 3D in order to obtain a bio-faithful geometry, and then study the behavior of different types of biomaterials that can replace bone grafting. To this end, three arm abduction motions were examined for three individuals. From the results obtained, it appears that grafts in ultra-high molecular weight polyethylene (UHMWPE) exhibit a behavior closer to that of bones.
The treatment of aortic aneurysm varies according to each patient. Stent implantation is one of many methods used to stabilize diseases. The information obtained from hemodynamic parameters in the pathological aorta with stent could help doctors in choosing the treatment before the surgery. In this context, the numerical simulation of fluid dynamics is an essential tool that can give us more detailed information that could be exploited by surgeons to find appropriate solutions to some pathologies. In this work, a study of two models of aortas: with and without stent was presented. A comparison of the results of changes in pressures and shear stresses of aortas in systolic and diastolic phases was discussed. The obtained results show a nearly similar tendency of variation for both models, which justifies the effectiveness of the type of stent chosen and its effect on the improvement of the blood flow. The methodology used in this work has revealed the detailed and necessary information for both cases studied and has shown the interest of the numerical tools for diagnosis and surgery.
Despite the widespread use of reverse total shoulder arthroplasty, there is still a problem of conflict between the polyethylene cup of the prosthesis and the scapula, which over time causes the phenomenon of notching. In order to circumvent this problem correctly, several innovations have been proposed regard to the implementation method. In this context, the aim of this work is to study the biomechanical behavior of new implantation methods using different glenoid configurations in order to avoid the notching phenomenon between the cup and the scapula. The study was performed using virtual prototypes of the shoulder prosthesis assembly. Using CT scan images, three-dimensional models of shoulder bones were reconstructed. The implantation of the prosthesis in the three-dimensional model was performed in collaboration with an experienced surgeon from the Caduceus Clinic (Oran, Algeria). The numerical models were imported to finite element calculation software. After the validation of the numerical model using the literature results, we assessed the biomechanical behavior of four implantation methods under the same boundary conditions and abduction movements. From the obtained results, it was found that among the proposed methods, the BIO-SR lateralization method offers significant biomechanical advantages in terms of the forces applied to the glenoid during the abduction movement.
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