Glenoid Component Failure in Total Shoulder Arthroplasty

Matsen, Frederick A.; Clinton, Jeremiah; Lynch, Joseph R.; Bertelsen, Alexander; Richardson, Michael L.

doi:10.2106/jbjs.g.01263

Cited by 288 publications

(182 citation statements)

References 90 publications

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“…However, this greater volumetric wear does not imply that the clinical loosening rates of the prosthesis will be three times higher. In anatomical prostheses, there are many reasons for loosening of the glenoid component [24]. Glenoid loosening is the main reason for revision of anatomical shoulder prostheses, in up to 12.5 % of cases.…”

Section: Discussionmentioning

confidence: 99%

“…Glenoid loosening is the main reason for revision of anatomical shoulder prostheses, in up to 12.5 % of cases. An inflammatory reaction to wear debris may not be the most important reason, in comparison with malalignment of the anatomical glenoid [24,25]. The revision rate for inverse prostheses with aseptic glenoid loosening is thus about 3.5 % [10].…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of a reconstruction reverse shoulder for tumour surgery and tribological comparision with an anatomical shoulder arthroplasty

Dieckmann

Liem

Gosheger

et al. 2013

International Orthopaedics (SICOT)

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Purpose The functional results after reconstruction of the proximal humerus in tumour surgery are poor. Therefore, a reversed proximal humerus replacement was developed in our institution (MUTARS humerus inverse). A low degree of wear on the polyethylene is required because of the patients' youth and demands on shoulder function. A special type of polyethylene with shock-absorbing properties has been developed to minimise polyethylene wear in the MUTARS inverse proximal humerus replacement. We compared the tribological properties of an anatomical shoulder prosthesis (CAPICA) with the new reversed proximal humerus replacement (MUTARS humerus inverse). Methods Both prostheses were tested up to 5×10 6 cycles. Every millionth cycle the surface was inspected and a gravimetric measurement was performed. A measurement of surface roughness was done before testing and after 5×10 6 cycles. Results In both prostheses after 5×10 6 cycles there were no major defects, such as delamination, observed. In the reversed proximal humerus replacement abrasion of 28 mg/ 10 6 cycles was detected. The mean abrasion of the anatomical prosthesis was 9.28 mg/ 10 6 cycles. Conclusion The glenoid component of the first reversed humerus replacement (MUTARS humerus inverse) has wear properties comparable to those of normal reversed shoulder prostheses. This is important, as this type of prosthesis is used in young patients after resection of bone tumours, with a good functional outcome. It can, therefore, be expected that the revision rate due to wear will be as high as in patients with normal reversed shoulder prostheses.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of a reconstruction reverse shoulder for tumour surgery and tribological comparision with an anatomical shoulder arthroplasty

Dieckmann

Liem

Gosheger

et al. 2013

International Orthopaedics (SICOT)

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“…It is associated with an increased rate of failure with conventional total shoulder arthroplasty [25,49], causing surgeons to consider more complex and potentially more risk-prone options, such as posterior glenoid bone grafting to add support to the prosthetic glenoid component [39] or reverse total shoulder arthroplasty [29]. The ream and run is a glenohumeral arthroplasty that combines humeral hemiarthroplasty with conservative glenoid reaming just sufficient to convert the biconcavity to a single concavity, but without attempting to normalize glenoid version and without insertion of a prosthetic glenoid component.…”

Section: Discussionmentioning

confidence: 99%

“…The humeral stem sizes used were 6 mm (1), 8 mm (one), 10 mm (10), 12 mm (13), and 14 mm (five). Head diameters of the curvature were 44 mm (one), 48 mm (one), 52 mm (three), and 56 mm (25). Head heights were 15 mm (seven), 18 mm (seven), and 21 mm (16).…”

Section: Methodsmentioning

confidence: 96%

Can the Ream and Run Procedure Improve Glenohumeral Relationships and Function for Shoulders With the Arthritic Triad?

Matsen

Warme

Jackins

2015

Clinical Orthopaedics &Amp; Related Research

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Background The arthritic triad of glenoid biconcavity, glenoid retroversion, and posterior displacement of the humeral head on the glenoid is associated with an increased risk of failure of total shoulder joint replacement. Although a number of glenohumeral arthroplasty techniques are being used to manage this complex pathology, problems with glenoid component failure remain. In that the ream and run procedure manages arthritic pathoanatomy without a glenoid component, we sought evidence that this procedure can be effective in improving the centering of the humeral head contact on the glenoid and in improving the comfort and function of shoulders with the arthritic triad without the risk of glenoid component failure.Questions/purposes We asked, for shoulders with the arthritic triad, whether the ream and run procedure could improve glenohumeral relationships as measured on standardized axillary radiographs and patient-reported shoulder comfort and function as recorded by the Simple Shoulder Test. Methods Between January 1, 2006 and December 14, 2011, we performed 531 primary anatomic glenohumeral arthroplasties for arthritis, of which 221 (42%) were ream and run procedures. Of these, 30 shoulders in 30 patients had the ream and run procedure for the arthritic triad and had two years of clinical and radiographic follow-up. These 30 shoulders formed the basis for this case series. The average age of the patients was 56 ± 8 years; all but one were male. Two of the 30 patients requested revision to total shoulder arthroplasty within the first year after their ream and run procedure because of their dissatisfaction with their rehabilitation progress. For the 28 shoulders not having had a revision, we determined on the standardized axillary views before and after surgery the glenoid type, glenoid version (90°minus the angle between the plane of the glenoid face and the plane of the body of the scapula), and location of the humeral contact point with respect to the anteroposterio dimension of the glenoid (the ratio of the distance from the anterior glenoid lip to the contact point divided by the distance between the anterior and posterior glenoid lips). We also recorded the patient's self-assessed shoulder comfort and function before and after surgery using the 12 questions of the Simple Shoulder Test. Results For the 28 unrevised shoulders the mean followup was 3.0 years (range, 2-9.2 years). In these patients, the ream and run procedure resulted in improved centering of the humeral head on the face of the glenoid (preoperative: 75% ± 7% posterior; postoperative: 59% ± 10% posterior; mean difference 16% [95% CI, 13%-19%]; p \ 0.001), notably this improved centering was achieved

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“…It is imperative to monitor contact loads across the entire area, wherein the measurement of loads at discrete points on (or within) the implant is of particular interest since certain joint forces measured using the aforementioned techniques do not seem significant in terms of body weight, yet if these loads are concentrated on a single point they can result in wear and plastic deformation of the UHMWPE component [14]. This measuring technique will result as an improved understanding of force transmission mechanisms encountered by these implants in service and could lead to better designs, and ultimately, a reduction in notching and longer implant lifespans [15][16][17][18][19]. Polymers enable an approximation of the characteristics of the implant without a modification to the implant's internal structure, which leads to a more accurate measurement of the internal loads.…”

Section: Introductionmentioning

confidence: 99%

Embedded Conjugated Polymer Sensor Arrays for Load Transmission Measurement in Orthopaedic Implants

Micolini¹,

Holness²,

Johnson³

et al. 2017

Preprint

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Load transfer through orthopaedic joint implants is poorly understood. The longer-term outcomes of these implants are just starting to be studied, making it imperative to monitor contact loads across the entire joint implant interface to elucidate the force transmission and distribution mechanisms exhibited by these implants in service. This study proposes and demonstrates the design, implementation, and characterization of a 3D-printed smart polymer sensor array using conductive polyaniline (PANI) structures embedded within a polymeric parent phase. The piezoresistive characteristics of PANI were studied to characterize the sensing behaviours inherent to these embedded pressure sensor arrays. PANI's stable response to a continuous load, its stability throughout loading and unloading cycles, and its repeatable and linear response to incremental loading cycles together with the accuracy of these measurements were investigated. It is demonstrated that this specially developed multi-material additive manufacturing process for polyaniline is an attractive approach for the fabrication of implant components having embedded smart-polymer sensors for the measurement and analysis of joint loads in orthopaedic implants.

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Glenoid Component Failure in Total Shoulder Arthroplasty

Cited by 288 publications

References 90 publications

Evaluation of a reconstruction reverse shoulder for tumour surgery and tribological comparision with an anatomical shoulder arthroplasty

Evaluation of a reconstruction reverse shoulder for tumour surgery and tribological comparision with an anatomical shoulder arthroplasty

Can the Ream and Run Procedure Improve Glenohumeral Relationships and Function for Shoulders With the Arthritic Triad?

Embedded Conjugated Polymer Sensor Arrays for Load Transmission Measurement in Orthopaedic Implants

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