Stress analysis of glenoid component in design of reverse shoulder prosthesis using finite element method

Yang, Ching‐Chieh; Lu, Chi; Wu, Changxu; Wu, Jiunn-Jer; Huang, Tzung-Chi; Chen, Rongshun; Yeh, Meng‐Kao

doi:10.1016/j.jse.2012.09.001

Cited by 42 publications

(26 citation statements)

References 25 publications

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“…In terms of displacement, however, both the 36 and 42 mm glenosphere in our study had displacement less that the 150 μm threshold that has been cited as guideline to remain below to encourage osseous integration . Yang et al also reported that divergent screw placement decreased stress and displacement . Our results are in support of their findings.…”

Section: Discussionsupporting

confidence: 88%

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Finite element analysis of glenoid-sided lateralization in reverse shoulder arthroplasty

et al. 2016

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The purpose of this study was to evaluate glenoid-sided lateralization in reverse shoulder arthroplasty (RSA), and compare bony and prosthetic lateralization. The hypothesis was that stress and displacement would increase with progressive bony lateralization, and be lower with prosthetic lateralization. A 3D finite element analysis (FEA) was performed on a commercially available RSA prosthesis. Stress and displacement were evaluated at baseline and following 5, 10, and 15 mm of bony or prosthetic lateralization. Additional variables included glenosphere size, baseplate orientation, and peripheral screw orientation. Maximum stress for a 36 mm glenosphere without bone graft increased by 137% for the 5 mm graft, 187% for the 10 mm graft, and 196% for the 15 mm graft. Likewise, displacement progressively increased with increasing graft thickness. Stress and displacement were reduced with a smaller glenosphere, inferior tilt of the baseplate, and divergent peripheral screws. Compared to bony lateralization, stress was lower with prosthetic lateralization through the glenosphere or baseplate. Displacement with 5 mm of bony lateralization reached recommended maximal amounts for osseous integration, whereas, this level was not reached until 10-15 mm of prosthetic lateralization. Baseplate stress and displacement in an FEA model is lower with a smaller glenosphere, inferior tilt, and divergent screws. Bony lateralization increases stress and displacement to a greater degree than prosthetic lateralization. It appears that at least 10 mm of prosthetic lateralization is mechanically acceptable during RSA, but only 5 mm of bony lateralization is advised. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1548-1555, 2017.

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Section: Discussionsupporting

confidence: 88%

“…Yang et al performed a 2D FEA using a circular 29 mm baseplate (Aequalis Reversed; Tornier, Inc., Edina, MN) . They noted that increasing glenosphere size from 36 to 42 mm resulted in a 2% increase in stress with no change at 42 mm.…”

Section: Discussionmentioning

confidence: 99%

Finite element analysis of glenoid-sided lateralization in reverse shoulder arthroplasty

et al. 2016

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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: 70%

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

127

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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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“…This should reduce the incidence of scapular notching but there will be a greater stress on the baseplate in this position with a higher probability of loosening [43, 44]. …”

Section: Glenosphere Optionsmentioning

confidence: 99%

A Critical Review on Prosthetic Features Available for Reversed Total Shoulder Arthroplasty

Middernacht

Tongel

Wilde

2016

BioMed Research International

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Reversed total shoulder arthroplasty is a popular treatment in rotator cuff arthropathy and in displaced proximal humeral fractures in elderly. In 2016, 29 models of commercially available designs express this popularity. This study describes all the different design parameters available on the market. Prosthetic differences are found for the baseplate, glenosphere, polyethylene, and humeral component and these differences need to be weighed out carefully for each patient knowing that a gain in one mechanical parameter can balance the loss of another. Patient specific implants may help in the future.

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Stress analysis of glenoid component in design of reverse shoulder prosthesis using finite element method

Cited by 42 publications

References 25 publications

Finite element analysis of glenoid-sided lateralization in reverse shoulder arthroplasty

Finite element analysis of glenoid-sided lateralization in reverse shoulder arthroplasty

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

A Critical Review on Prosthetic Features Available for Reversed Total Shoulder Arthroplasty

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