Implant positioning in reverse shoulder arthroplasty has an impact on acromial stresses

Wong, Murray T.; Langohr, G. Daniel G.; Athwal, George S.; Johnson, James A.

doi:10.1016/j.jse.2016.04.011

Cited by 113 publications

(66 citation statements)

References 29 publications

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“…Other studies associated the position of the centre of rotation (COR) and the design of the reverse prosthesis with scapula fractures [26,29,44]. Schenk et al [29] reported an increase of acromial fractures with high medialization and little distalization of the COR.…”

Section: Discussionmentioning

confidence: 99%

Causes of acromion and scapular spine fractures following reverse shoulder arthroplasty: a retrospective analysis and literature review

Nyffeler

Altioklar

Bissig

2020

International Orthopaedics (SICOT)

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Purpose Fractures of the acromion and the scapular spine are serious complications after reverse total shoulder arthroplasty. They concern about 4 to 5% of the patients and always result in a significant deterioration of shoulder function. Different causes have been taken into consideration, particularly stress or fatigue fractures. The purpose of the present study was to analyse our own cases and to discuss the causes reported in the literature. Methods We reviewed our shoulder arthroplasty registry and the consultation reports of the last ten years. The charts and radiographs of all patients who had a post-operative fracture of the acromion or the scapular spine were carefully examined and the results were compared with those of an age- and gender-matched control group. Results Twelve patients with an average age of 79 years sustained a fracture of the acromion (n = 6) or the scapular spine (n = 6). The time interval between the operation and the fracture averaged 26 months and ranged from three weeks to 70 months. Eight patients (67%) had a trauma. Seven of them reported a fall on the corresponding shoulder and one a heavy blow on the acromion. The four non-traumatic fractures were attributed to poor bone quality. All 12 patients had immediate pain and difficulty to actively elevate the affected arm. The time interval between the fracture and its diagnosis averaged ten weeks (0 to 10 months). At final follow-up, all patients could reach their face and refused further surgery. Two patients rated their result as good, six as acceptable and four as poor. Conclusions Our study cannot support the hypothesis that most acromion and scapular spine fractures after RSA are the result of increased tension in the deltoid or stress fractures. In our series, the majority of the fractures were related to a fall. Implantation of a reverse prosthesis exposes the acromion and makes it more vulnerable to direct trauma. Non-traumatic fractures were associated with poor bone quality.

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Section: Discussionmentioning

confidence: 99%

Causes of acromion and scapular spine fractures following reverse shoulder arthroplasty: a retrospective analysis and literature review

Nyffeler

Altioklar

Bissig

2020

International Orthopaedics (SICOT)

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“…Currently, a PubMed search of "reverse shoulder arthroplasty finite element" returns 16 total articles, including two articles generated by this lab. Many of these articles focus on glenosphere fixation and the stresses generated by the fixation in the glenoid region, as well as micromotion of the glenoid fixation [69][70][71][72][73][74][75][76][77][78]. Although such research is important in ensuring the safety of glenoid fixation, the models used to study glenosphere fixation are fairly simplistic, especially when compared to other orthopaedic and arthroplasty research available in the literature [79][80][81][82][83].…”

Section: Rsa Fe Modelingmentioning

confidence: 99%

Development of a computational model to study instability and scapular notching in reverse shoulder arthroplasty

Permeswaran¹

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“…La carga de 400 N correspondió a la carga más grande observada durante la abducción (Langohr, et al, 2016). Wong, et al (2016) utiliza una metodología similar, crearon un modelo computacional para calcular los vectores de fuerza a través de la abducción de 7 secciones del deltoides, para rezalizar el modelo se utiliza un arco de movimiento de abducción cada 15°, entre 0° y 120°.…”

Section: Método De Elementos Finitos Para Modelos De Artroplastia Invunclassified

“…La reducción del ángulo del cuello humeral y de la profundidad de la copa redujeron el área de contacto y aumentaron el estrés pico de contacto. Wong, et al (2016) Evaluar el efecto de la posición del implante húmero y glenoideo RSA sobre las tensiones acromiales.…”

Section: Referenciaunclassified

“…El posicionamiento inferior y medial de la glenosfera sirve para disminuir el estrés acromial, que se cree que se debe principalmente a una mayor ventaja mecánica del deltoides (Wong, et al, 2016). La tesis se desarrolló con esta condición de posicionamiento, en trabajos futuros se recomienda cambiar la posición de la placa base y la glenosfera e identificar los cambios de la distribución de tensiones.…”

Section: Modelo Fotoelástico De La Articulación Del Hombro Con Rsaunclassified

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Aplicación de técnicas experimentales optomecánicas de campo continuo para el análisis de tensiones y deformaciones en la articulación del hombro humano

Galárraga¹,

Alfonso²

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Implant positioning in reverse shoulder arthroplasty has an impact on acromial stresses

Cited by 113 publications

References 29 publications

Causes of acromion and scapular spine fractures following reverse shoulder arthroplasty: a retrospective analysis and literature review

Causes of acromion and scapular spine fractures following reverse shoulder arthroplasty: a retrospective analysis and literature review

Development of a computational model to study instability and scapular notching in reverse shoulder arthroplasty

Aplicación de técnicas experimentales optomecánicas de campo continuo para el análisis de tensiones y deformaciones en la articulación del hombro humano

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