Influence of the medial offset of the proximal humerus on the glenohumeral destabilising forces during arm elevation: a numerical sensitivity study

Lemieux, Pierre-Olivier; Hagemeister, Nicola; Tétreault, Patrice; Nuño, Natalia

doi:10.1080/10255842.2011.607813

Cited by 13 publications

(4 citation statements)

References 35 publications

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“…In addition, the critical shoulder angle metric utilized by Moor et al 17) was also implemented in a modified fashion relative to the scapular coordinate system used in this study (γ). The abduction lever arm of the middle deltoid (G, V) was determined according to a modified methodology of Cabezas et al 14) and Lemieux et al 18) …”

Section: Methodsmentioning

confidence: 99%

Morphologic Variability of the Shoulder between the Populations of North American and East Asian

et al. 2016

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BackgroundThe aim of this study was to determine if there were significant differences in glenohumeral joint morphology between North American and East Asian populations that may influence sizing and selection of shoulder arthroplasty systems.MethodsComputed tomography reconstructions of 92 North American and 58 East Asian patients were used to perform 3-dimensional measurements. The proximal humeral position was normalized in all patients by aligning it with the scapular plane utilizing anatomic landmarks. Measurements were performed on the humerus and scapula and included coronal and axial humeral head radius, humeral neck shaft and articular arc angles, glenoid height and width, and critical shoulder angle. Glenohumeral relationships were also measured and included lateral distance to the greater tuberosity and acromion, abduction lever arm, and acromial index. Parametric and nonparametric statistical analyses were used to compare population metrics.ResultsEast Asian glenohumeral measurements were significantly smaller for all linear metrics (p < 0.05), with the exception of acromial length, which was greater than in the North American cohort (p < 0.001). The increase in acromial length affected all measurements involving the acromion including abduction lever arms. No difference was found between the neck shaft and articular angular measurements.ConclusionsThe East Asian population exhibited smaller shoulder morphometrics than their North American cohort, with the exception of an extended acromial overhang. The morphologic data can provide some additional factors to consider when choosing an optimal shoulder implant for the East Asian population, in addition to creating future designs that may better accommodate this population.

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Section: Methodsmentioning

confidence: 99%

Morphologic Variability of the Shoulder between the Populations of North American and East Asian

et al. 2016

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“…A more detailed description of this model can be found in Damsgaard et al [23] and Lemieux et al [24]. This 3D musculoskeletal model consists of 21 bones (treated as rigid body segments), 32 bilateral upper body muscles and 19 spine muscles.…”

Section: Musculoskeletal Modelingmentioning

confidence: 99%

Muscle load in reaching movements performed by a wheelchair user: a case study

Drongelen

Wolf

Fradet

2013

Disability and Rehabilitation

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Handling heavy objects such as a pack of bottles or a wheelchair produces high forces on the rotator cuff muscles and can lead to early fatigue. Therefore, these activities seem to be associated with a high risk of developing impingement syndrome. Implications for Rehabilitation In a single patient, this study demonstrates that the load on the rotator cuff is high during reaching movements. Handling a pack of water bottles, which resembles wheelchair handling, represents an activity associated with a high risk of developing impingement syndrome. Shoulder muscles must be trained in a balanced way to provide stabilization at the shoulder joint and prevent fatigue.

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“…This more lateral positioning with an onlay humeral rTSA prosthesis lengthens the deltoid moment arm to improve joint efficiency and also better restores deltoid wrapping around the greater tuberosity. Greater deltoid wrapping offers the potential for improved joint stability [ 66 , 67 , 68 , 69 ]. More medialized reverse shoulder prostheses are associated with less deltoid wrapping, which reduces the horizontal stabilizing compressive force vector of the deltoid and may increase the risk of dislocation, particularly in cases of substantial medial glenoid wear [ 70 ] ( Figure 5 ).…”

Section: Rtsa Prosthesis Design Considerations On Biomechanicsmentioning

confidence: 99%

Reverse Shoulder Arthroplasty Biomechanics

Roche

2022

JFMK

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The reverse total shoulder arthroplasty (rTSA) prosthesis has been demonstrated to be a viable treatment option for a variety of end-stage degenerative conditions of the shoulder. The clinical success of this prosthesis is at least partially due to its unique biomechanical advantages. As taught by Paul Grammont, the medialized center of rotation fixed-fulcrum prosthesis increases the deltoid abductor moment arm lengths and improves deltoid efficiency relative to the native shoulder. All modern reverse shoulder prostheses utilize this medialized center of rotation (CoR) design concept; however, some differences in outcomes and complications have been observed between rTSA prostheses. Such differences in outcomes can at least partially be explained by the impact of glenoid and humeral prosthesis design parameters, surgical technique, implant positioning, patient-specific bone morphology, and usage in humeral and glenoid bone loss situations on reverse shoulder biomechanics. Ultimately, a better understanding of the reverse shoulder biomechanical principles will guide future innovations and further improve clinical outcomes.

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Influence of the medial offset of the proximal humerus on the glenohumeral destabilising forces during arm elevation: a numerical sensitivity study

Cited by 13 publications

References 35 publications

Morphologic Variability of the Shoulder between the Populations of North American and East Asian

Morphologic Variability of the Shoulder between the Populations of North American and East Asian

Muscle load in reaching movements performed by a wheelchair user: a case study

Reverse Shoulder Arthroplasty Biomechanics

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