The effect of humeral polyethylene insert constraint on reverse shoulder arthroplasty biomechanics

Abdulla, Irfan; Langohr, Daniel G.; Giles, Joshua W.; Johnson, James A.; Athwal, George S.

doi:10.1177/1758573217701065

Cited by 16 publications

(6 citation statements)

References 27 publications

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“… 130 Lastly, humeral socket depth defined in ratio to glenosphere diameter will increase stability at the potential cost of a reduced range of motion. 139 , 144 , 152 …”

Section: Reverse Shoulder Arthroplastymentioning

confidence: 99%

Biomechanics of anatomic and reverse shoulder arthroplasty

et al. 2021

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The biomechanics of the shoulder relies on careful balancing between stability and mobility. A thorough understanding of normal and degenerative shoulder anatomy is necessary, as the goal of anatomic total shoulder arthroplasty is to reproduce premorbid shoulder kinematics. With reported joint reaction forces up to 2.4 times bodyweight, failure to restore anatomy and therefore provide a stable fulcrum will result in early implant failure secondary to glenoid loosening. The high variability of proximal humeral anatomy can be addressed with modular stems or stemless humeral components. The development of three-dimensional planning has led to a better understanding of the complex nature of glenoid bone deformity in eccentric osteoarthritis. The treatment of cuff tear arthropathy patients was revolutionized by the arrival of Grammont’s reverse shoulder arthroplasty. The initial design medialized the centre of rotation and distalized the humerus, allowing up to a 42% increase in the deltoid moment arm. More modern reverse designs have maintained the element of restored stability but sought a more anatomic postoperative position to minimize complications and maximize rotational range of motion. Cite this article: EFORT Open Rev 2021;6:918-931. DOI: 10.1302/2058-5241.6.210014

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“… 130 Lastly, humeral socket depth defined in ratio to glenosphere diameter will increase stability at the potential cost of a reduced range of motion. 139 , 144 , 152 …”

Section: Reverse Shoulder Arthroplastymentioning

confidence: 99%

Biomechanics of anatomic and reverse shoulder arthroplasty

et al. 2021

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“…Finally, he concluded when the constraint joint was implanted to improve the joint stability, joint load and deltoid forces during active abduction were not affected signi cantly. Simultaneously, the range of motion was also not signi cantly different from that of a conventional reverse shoulder [21].…”

Section: Discussionmentioning

confidence: 75%

3d Printed Customized Total Scapular Replacement With Constrained Shoulder Joint After Wide Resection For Scapula Chondrosarcoma Treatment: A Case Report

Tran¹,

Dang²,

Tran³

et al. 2021

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IntroductionTotal scapular replacement surgery with constrained reverse shoulder joint a complex surgery, especially in the selection of replacement materials. The advent of three-dimensional (3D) printing technique contribute significantly to the success of surgeryCase presentationA 62-year-old female patient discovered a scapular tumor at the end of 2017. She underwent curettage and bone graft surgery 3 times. The histopathological diagnosis was enchondroma. However, tumor recurrence and malignant transformation unfortunately presented later. She visited our center and total scapular replacement with constrained reverse shoulder joint was then performed. After 6 months, the patient's functional outcome was evaluated by using Musculoskeletal Tumour Society Score (MSTS) with a score of 26/30. There was no sign of local tumor recurrence. The functional of elbow and hand was preserved almost completely. The range of active movement of the shoulder was 60° for forward flexion and abduction, and 45° for backward flexion.DiscussionDespite the follow-up time was still short, the use of the constrained shoulder joint with the applications of patient-specific 3D printing showed very positive outcomes. Patient was able to start rehabilitative early without any problems. More follow-up time would be needed to evaluate the long-term effectiveness of this method.ConclusionTotal scapular replacement with constrained reverse shoulder joint using 3D printing technology is a suitable option for the patients with scapular tumor invading the muscles of the rotator cuff.

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“…The authors concluded that polyethylene constraint had limited effect on RTSA kinematics. 1 It should be noted, however, that biomechanical studies primarily evaluate glenohumeral motion, while clinically, motion after RTSA involves both glenohumeral and scapulothoracic motion, so these biomechanical findings may not translate directly to what is observed clinically.…”

Section: Discussionmentioning

confidence: 99%