The effect of glenoid bone loss on reverse shoulder arthroplasty baseplate fixation

Formaini, Nathan T.; Everding, Nathan G.; Levy, Jonathan C.; Santoni, Brandon G.; Nayak, Aniruddh N.; Wilson, Cooper; Cabezas, Andres F.

doi:10.1016/j.jse.2015.05.045

Cited by 75 publications

(43 citation statements)

References 26 publications

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“…These materials were selected in accordance to American Society Testing and Materials (ASTM) Standard F1839. Similar foam block densities have been used in prior RSA studies to biomechanically evaluate factors that may impact baseplate fixation, including baseplate design, glenoid bone loss and bone density, and peripheral screws configurations . We found that increasing insertion torque was associated with significantly higher mean baseplate compression across the three surrogate bone densities that were tested, with higher mean baseplate compression observed with increasing surrogate bone density.…”

Section: Discussionmentioning

confidence: 56%

“…The initial applied torque and baseplate compression are critical to achieve this stable bone‐to‐implant interface. Prior studies have shown that micromotion below 150 µm between an implant and bone is optimal in achieving a biological environment for stable fixation, with subsequent RSA biomechanical studies using this cut‐off as an acceptable level when assessing factors that impact baseplate fixation . Formaini et al inserted and tightened a baseplate to a maximum torque of 3.5 Nm (roughly 31 in‐lbf) with peripheral screws torqued to 0.7 Nm (roughly 6 in‐lbf) and showed that different combinations of hybrid peripheral screw fixation (locking and non‐locking) resulted in secure baseplate fixation.…”

Section: Discussionmentioning

confidence: 99%

“…Because the assumption that a screw‐in baseplate requires bicortical fixation has not been validated, we elected to use uniform density foam blocks. This model has been widely used in the published literature …”

Section: Discussionmentioning

confidence: 99%

“…Initial fixation of non‐cemented implants is critical to achieve a stable bone‐to‐implant interface during the first few months after surgery to potentiate bone ingrowth and avoid aseptic loosening . Minimization of micromotion to less than 150 µm between an implant and bone has been shown to be optimal in achieving a biological environment for bone growth onto metal arthroplasty surfaces . Frankle et al used scanning electron microscopy to determine possible modes of failure and identify whether bony ingrowth had occurred.…”

mentioning

confidence: 99%

“…3,[16][17][18] Minimization of micromotion to less than 150 µm between an implant and bone has been shown to be optimal in achieving a biological environment for bone growth onto metal arthroplasty surfaces. [16][17][18][19][20][21] Frankle et al 22 used scanning electron microscopy to determine possible modes of failure and identify whether bony ingrowth had occurred. The lack of bony ingrowth on the porous underside of the baseplate was associated with cyclic baseplate failure.…”

mentioning

confidence: 99%

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Relationship Between Insertion Torque and Compression Strength in the Reverse Total Shoulder Arthroplasty Baseplate

Diaz

Garrigues

Ricchetti

et al. 2019

Journal Orthopaedic Research

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Reverse shoulder arthroplasty is a well‐established procedure, however, there is limited data in the literature regarding adequate insertion torque and the resulting compression for glenoid baseplate fixation. In this biomechanical study, we evaluated the relationship between insertion torque and baseplate compression by simultaneously measuring the insertion torque and axial compressive forces generated by two reverse shoulder arthroplasty baseplates with central screw design. Three different bone surrogates were chosen to mimic clinical scenarios where differences in compression achieved during baseplate insertion may exist due to varying bone quality. Epoxy resin sheets were combined with the bone surrogates to simulate the glenoid vault. A digital torque gauge was used to measure insertion torque applied to the baseplate, while compression data were collected continuously from a load cell. A strong positive correlation was found between baseplate compression and insertion torque. Among the lower density bone surrogates, neither baseplate design reached maximum insertion torque (6.8 Nm) due to material strip‐out. This phenomenon did not occur in denser bone surrogates. Both baseplate designs experienced a significant increase in mean baseplate compression as insertion torque increased and were found to behave similar in the denser bone surrogates. The results presented here suggest that larger compressive forces can be achieved with an increase in insertion torque in denser bone surrogates, but caution must be used when trying to achieve fixation in poor‐quality bone. Clinically, this could be useful preoperatively to minimize baseplate failure, and in further studies regarding baseplate design for improved initial fixation and stability. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:871‐879, 2020

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Relationship Between Insertion Torque and Compression Strength in the Reverse Total Shoulder Arthroplasty Baseplate

Diaz

Garrigues

Ricchetti

et al. 2019

Journal Orthopaedic Research

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Image processing methodology for patient‐specific instrument design

Sadeghi

Keçeci

2020

Robotics Computer Surgery

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Background: Patient-specific instrumentation (PSI) improves accuracy of surgical operations. PSI needs software for preoperative planning and instrument design. In this study, we explain the methodology of developing a software tool for PSI guide design and preoperative planning in reverse shoulder arthroplasty (RSA). Methods: Approaches used to prepare input data, transform them into meaningful features and use of those features to create special guide geometries are explained by describing different algorithms and libraries. Results: The developed software is tested on three different patients' data. Preoperative planning is performed and guides designed by software and the patients' bones are manufactured and tested for RSA. The method of building a software is presented to do the preoperative planning and designing specific guides for each patient are shown to be properly functional. Conclusions: This study proves processes in the development of the PSI software and the design of a specific guide for RSA.

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