Reverse shoulder arthroplasty for massive cuff tears in patients &lt;65 years: An age-old dilemma

Kennon, Justin C.; Crosby, Lynn A.

doi:10.1053/j.sart.2015.02.006

Cited by 1 publication

(1 citation statement)

References 27 publications

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“…If better designs are desired, it may be necessary to devise ways to reduce the stress on the upper screw. Regarding scapular spine fractures after RSA, Kennon et al reported significantly more scapular and scapular spine fractures in the group where an upper screw was inserted [21]. The idea that higher stresses around the upper screw will likely lead to more fractures is consistent with the stress distribution results.…”

Section: Discussionmentioning

confidence: 67%

Stresses in the Scapular Fossa Do Not Exceed the Yield Stress When Elevated up to 135 Degrees of Abduction after Reverse Shoulder Arthroplasty

Sakai,

Kenmoku,

Tazawa

et al. 2024

JBiSE

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Reverse shoulder arthroplasty (RSA) is an effective treatment for rotator cuff tears. Despite its advantages, complications occur at a high rate. Complications requiring revision include a high rate of base plate failure, 38% of which are due to instability. The primary stability the base plate ensures is a crucial factor and, thus, is the subject of much debate in clinical studies and biomechanical research. This study is aimed to provide data that will contribute to the base plate's primary stability and glenoid longevity by clarifying the stresses at the scapular fossa and base plate interface associated with elevation after RSA. A 3D finite element model was created from the DICOM data for the scapulohumeral joint and SMR shoulder system. For loading conditions, 30 N was applied for each position with abduction angles of 0, 45, 90, and 135 degrees. A three-dimensional finite element analysis was performed using the static implicit method with LS-DYNA. The von Mises stresses in the scapular fossa were found not to exceed the yield stress on the bone even after elevation to an abduction angle of 135 degrees after RSA. It is rough to uniformly compare the yield stress and the von Mises stress, but it was inferred that the possibility of fracture is low unless a large external force is applied. A maximum von Mises stress showed 0 degrees of abduction, suggesting that the lowered position is in a more severe condition than the elevated position. If better improvement is desired, it may be necessary to devise ways to reduce the stress on the upper screw.

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Section: Discussionmentioning

confidence: 67%