In vivo gleno-humeral joint loads during forward flexion and abduction

Bergmann, G.; Graichen, F.; Bender, Alwina; Rohlmann, A.; Halder, Andreas M.; Beier, Alexander; Westerhoff, P.

doi:10.1016/j.jbiomech.2011.02.142

Cited by 134 publications

(99 citation statements)

References 23 publications

(26 reference statements)

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“…Our numerical results are consistent with these in vivo measurements. The numerical prediction for glenohumeral joint force was in agreement with in vivo measurements for abduction angles under 908 elevation (Bergmann et al 2011). Above 908 elevation, the experimental data showed a continuous increase while the numerical model predicted a decrease.…”

Section: Discussionsupporting

confidence: 78%

Comparison of an EMG-based and a stress-based method to predict shoulder muscle forces

Engelhardt

Camine

Ingram

et al. 2014

Computer Methods in Biomechanics and Biomedical Engineering

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The estimation of muscle forces in musculoskeletal shoulder models is still controversial. Two different methods are widely used to solve the indeterminacy of the system: electromyography (EMG)-based methods and stress-based methods. The goal of this work was to evaluate the influence of these two methods on the prediction of muscle forces, glenohumeral load and joint stability after total shoulder arthroplasty. An EMG-based and a stress-based method were implemented into the same musculoskeletal shoulder model. The model replicated the glenohumeral joint after total shoulder arthroplasty. It contained the scapula, the humerus, the joint prosthesis, the rotator cuff muscles supraspinatus, subscapularis and infraspinatus and the middle, anterior and posterior deltoid muscles. A movement of abduction was simulated in the plane of the scapula. The EMG-based method replicated muscular activity of experimentally measured EMG. The stress-based method minimised a cost function based on muscle stresses. We compared muscle forces, joint reaction force, articular contact pressure and translation of the humeral head. The stress-based method predicted a lower force of the rotator cuff muscles. This was partly counter-balanced by a higher force of the middle part of the deltoid muscle. As a consequence, the stress-based method predicted a lower joint load (16% reduced) and a higher superior -inferior translation of the humeral head (increased by 1.2 mm). The EMG-based method has the advantage of replicating the observed cocontraction of stabilising muscles of the rotator cuff. This method is, however, limited to available EMG measurements. The stress-based method has thus an advantage of flexibility, but may overestimate glenohumeral subluxation.

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Section: Discussionsupporting

confidence: 78%

Comparison of an EMG-based and a stress-based method to predict shoulder muscle forces

Engelhardt

Camine

Ingram

et al. 2014

Computer Methods in Biomechanics and Biomedical Engineering

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“…As noted above, this effect would be further exacerbated by more challenging daily tasks which involve resistive loads. These large increases in joint loading, which correspond to approximately 25% of the in vivo joint load measured by Bergmann et al [5] after primary TSA, may lead to increased polyethylene wear, as was observed by Nam et al [26], and will increase the loads experienced at the glenosphere baseplate, which has the potential to negatively affect fixation [35]. This, therefore, adds additional evidence in support of the potentially damaging side effects caused by decreasing the effectiveness of the shoulder's musculature through the use of glenosphere lateralization.…”

Section: Discussionmentioning

confidence: 55%

Implant Design Variations in Reverse Total Shoulder Arthroplasty Influence the Required Deltoid Force and Resultant Joint Load

Giles

Langohr

Johnson

et al. 2015

Clinical Orthopaedics &Amp; Related Research

133

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Background Reverse total shoulder arthroplasty (RTSA) is widely used; however, the effects of RTSA geometric parameters on joint and muscle loading, which strongly influence implant survivorship and long-term function, are not well understood. By investigating these parameters, it should be possible to objectively optimize RTSA design and implantation technique. Questions/purposes The purposes of this study were to evaluate the effect of RTSA implant design parameters on (1) the deltoid muscle forces required to produce abduction, and (2) the magnitude of joint load and (3) the loading angle throughout this motion. We also sought to determine how these parameters interacted.Methods Seven cadaveric shoulders were tested using a muscle load-driven in vitro simulator to achieve repeatable motions. The effects of three implant parameters-humeral lateralization (0, 5, 10 mm), polyethylene thickness (3, 6, 9 mm), and glenosphere lateralization (0, 5, 10 mm)-were assessed for the three outcomes: deltoid muscle force required to produce abduction, magnitude of joint load, and joint loading angle throughout abduction. Results Increasing humeral lateralization decreased deltoid forces required for active abduction (0 mm: 68% ± 8% [95% CI, 60%-76% body weight (BW)]; 10 mm: 65% ± 8% [95% CI, 58%-72 % BW]; p = 0.022). Increasing glenosphere lateralization increased deltoid force (0 mm: 61% ± 8% [95% CI, 55%-68% BW]; 10 mm: 70% ± 11% [95% CI, 60%-81% BW]; p = 0.007) and joint loads (0 mm: 53% ± 8% [95% CI, 46%-61% BW]; 10 mm: 70% ± 10% [95% CI, 61%-79% BW]; p \ 0.001). Increasing polyethylene cup thickness increased deltoid force (3 mm: 65% ± 8% [95% CI, 56%-73% BW]; 9 mm: 68% ± 8% [95% CI, 61%-75% BW]; p = 0.03) and joint load (3 mm: 60% ± 8% [95% CI, 53%-67% BW]; 9 mm: 64% ± 10% [95% CI, 56%-72% BW

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“…Bergmann et al conducted in vivo measurement of shoulder joint contact force. They showed that the shoulder joint contact force reached 1700 N (238 % of body weight) during forward flexion more than 90 degrees with 2 kg weight in the hand [28]. They also showed a reasonable compatibility between the shoulder joint contact force estimated by a musculoskeletal model and the measured force [29].…”

Section: Validity Of the Musculoskeletal Modelmentioning

confidence: 89%

Shoulder joint contact force during lever-propelled wheelchair propulsion

et al. 2015

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The aim of this study was to obtain quantitative results about shoulder contact force during wheelchair lever propulsion when the gear ratio of the lever propulsion mechanism is changing. The effect of the gear ratio on the shoulder contact force was investigated for few different wheelchair loading. For the experiments we designed a special mechatronic wheelchair simulator that allowed the simulation of different gear ratios of the wheelchair lever propulsion mechanism and simulation of different road inclinations. The same simulator was also used for simulation of a hand rim propelled wheelchair. We conducted also a handrim propulsion experiment and used the results from it for comparison with the lever propulsion data. Four nondisabled male adults with no prior wheeling experience participated in the experiment. In the first tests, a lever propelled wheelchair was simulated with the simulator. The target speed of the wheelchair was set to 2 km/h. For the test, the gear ratio was varied from 1.5 to 1/1.5. A load torque was applied to the rear wheels to imitate road inclinations of 0°, 2° and 4°. In the second part of the test, the simulator was structured to simulate a handrim propelled wheelchair. The participants were asked to keep the same speed (2 km/h) and the simulator was set sequentially to imitate climbing a ramp inclined on 0°, 2° and 4°. Kinematic data of the body were collected by a motion capture system. Kinetic data such as hand force and driving torque, were measured by instrumented wheels with incorporated six-axis force sensor. The intersegmental joint forces and moments were calculated from the obtained kinematic and kinetic data via inverse dynamics analysis procedure. Muscle forces were computed from the measured joint moments by using an optimization approach. Shoulder joint contact force, which indicates the joint surface loading, was computed as a synthetic vector of the intersegmental force for shoulder joint acquired from the inverse dynamics analysis and the compressive forces from muscles, tendons, ligaments and cartilages crossing the shoulder joint. It was observed that the decrease of the gear ratio causes increased cycle frequency and reduces the shoulder joint contact force. Result showed that the shoulder joint contact force during lever propulsion with a gear ratio 1/1.5 was up to 70 % lower than the shoulder joint contact force during handrim propulsion. The results from this study could be used in the design of new lever propulsion mechanisms that reduce the risks of secondary shoulder disorders and increase user's comfort.

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In vivo gleno-humeral joint loads during forward flexion and abduction

Cited by 134 publications

References 23 publications

Comparison of an EMG-based and a stress-based method to predict shoulder muscle forces

Comparison of an EMG-based and a stress-based method to predict shoulder muscle forces

Implant Design Variations in Reverse Total Shoulder Arthroplasty Influence the Required Deltoid Force and Resultant Joint Load

Shoulder joint contact force during lever-propelled wheelchair propulsion

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