Total shoulder replacement with a constrained prosthesis.

Post, Melvin; Haskell, S S; Jablon, Michael

doi:10.2106/00004623-198062030-00003

Cited by 93 publications

(22 citation statements)

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“…poor therapeutic 303 K. Tukuse c't ul. I Joirrritrl of' Ortliopurtlic Reserir-clr 22 (2004) [298][299][300][301][302][303][304][305] results in patients using the constrained type, because of marked limitations in range of motion or loosening of the glenoid component, were often reported [ 11, 21,34]. At pre ent, the non-constrained type is mainly practiced.…”

Section: Discussionmentioning

confidence: 99%

The radiographic study in the relationship of the glenohumeral joint

Takase¹,

Yamamoto²,

Imakiire³

et al. 2004

Journal Orthopaedic Research

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Accurate reproduction of anatomic relationship is important in non‐constrained prosthetic arthroplasty. The accurate lateral glenohumeral offset, which indicates a parameter of the lever arm of the deltoid and supraspinatus muscles, is one of the most important elements in achieving the efficient shoulder functions after prosthetic reconstruction. However, to our knowledge, there has been no detailed study on the influence of minute changes in the neck shaft angle, within the normal range, on lateral glenohumeral offset. In this study, we evaluated the relationship between the neck shaft angle and various geometric measurement values in the glenohumeral joint. Radiographs of 471 shoulders without osseous lesions in the glenohumeral joint and greater tuberosity were reviewed. There were 265 males and 206 females, and a mean age was 53.5 years old. The final diagnosis was impingement syndrome in 269 patients, rotator cuff tear in 147, and control group in 55 patients. Eight parameters were measured on true anteroposterior radiographs. The lateral glenohumeral offset correlated with the radius of the curvature of the humeral head and the humeral head diameter. The neck shaft angle was not correlated with the offset value. However, when the offset value was divided by the humeral head diameter, to eliminate the affection of the size of the humeral head toward the offset, a correlation was observed with the neck shaft angle. Based on these correlations, we could obtain the equation of the lateral glenohumeral offset according to the neck shaft angle. Using the equation, when the neck shaft angle is decided, the lateral glenohumeral offset can be estimated based on the correlation between the parameters, which achieve the efficient shoulder functions after prosthetic components. Therefore, inaccurate determination of the neck shaft angle in the humeral head component design and selection may induce dysfunction of the abductor muscles. © 2003 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.

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Section: Discussionmentioning

confidence: 99%

The radiographic study in the relationship of the glenohumeral joint

Takase¹,

Yamamoto²,

Imakiire³

et al. 2004

Journal Orthopaedic Research

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show abstract

“…11 However, clinical results were not encouraging, with high incidences of glenoid loosening and implant failure, 5,[12][13][14] and only limited gains of function and mobility when compared to less constrained designs. 7,[15][16][17] High loosening rates, possibly due to an increased bending moment applied through the fixation during eccentric loading, have also been noted. 5,12,13,14,17 In the nonpathological shoulder, the humeral head has been shown to translate across the glenoid surface during active motion.…”

Section: Introductionmentioning

confidence: 99%

“…7,[15][16][17] High loosening rates, possibly due to an increased bending moment applied through the fixation during eccentric loading, have also been noted. 5,12,13,14,17 In the nonpathological shoulder, the humeral head has been shown to translate across the glenoid surface during active motion. [18][19][20][21] Many total shoulder designs have therefore incorporated a level of nonconformity in an effort to return normal prepathological function to the joint.…”

Section: Introductionmentioning

confidence: 99%

Glenohumeral kinematics following total shoulder arthroplasty: A finite element investigation

Hopkins

Hansen

Amis

et al. 2006

Journal Orthopaedic Research

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ABSTRACT:The osseous geometry of the glenohumeral joint is naturally nonconforming and minimally constrained, and the joint's stability is maintained by action of the rotator cuff muscles. Damage to these muscles is often associated with joint degeneration, and a variety of glenoid prostheses have been developed to impart varying degrees of stability postoperatively. The issues of conformity and constraint within the artificial shoulder have been addressed through in vivo and in vitro studies, although few computational models have been presented. The current investigation presents the results of three-dimensional finite element analyses of the total shoulder joint and the effects of design parameters upon glenohumeral interaction. Conformity was shown not to influence the loads required to destabilize the joint, although it was the principal factor determining the magnitude of humeral head translation. Constraint was found to correlate linearly with the forces required to dislocate the humeral head, with higher constraint leading to slightly greater humeral migration at the point of joint instability. The model predicts that patients with a dysfunctional supraspinatus would experience frequent eccentric loading of the glenoid, especially in the superior direction, which would likely lead to increased fixation stresses, and hence, a greater chance of loosening. For candidates with an intact rotator cuff, the models developed in this study predict that angular constraints of at least 148 and 6.58 in the superoinferior and anteroposterior axes are required to provide stable unloaded abduction of the humerus, with larger constraints of 188 and 108 necessitated by a dysfunctional supraspinatus. The tools developed during this study can be used to determine the capacity for different implant designs to provide resistance to excessive glenohumeral translations and reduce the potential for instability of the joint, allowing surgeons to optimize postoperative functional gains on a patient by patient basis. ß

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“…Nevertheless, loosening remained as a severe problem in RSA. The glenoid component is typically the main point of loosening in total shoulder arthroplasty, especially with a constrained design (56,57). Boileau et al recognized some reasons concerning prosthesis loosing and suggested 3 possible solutions to prevent the following: (1) the use of a cemented humeral stem or perhaps a hybrid Trauma Mon.…”

Section: Prosthesis Looseningmentioning

confidence: 99%

A brief Review of Reverse Shoulder Prosthesis: Arthroplasty, Complications, Revisions, and Development

Özada¹,

Yazdi²,

Khandan³

et al. 2017

Trauma Mon

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Human shoulder is considered to be an important flexible and movable part in the human body. However, it is a wobble joint as its range of motion (ROM) is high. This unstable status causes the rate of joint injury. The processes leading to shoulder joint dysfunction are arthritis, hemiarthroplasty failure, and pseudoparalysis; in turn, one of the main factors contributing to these problems is rotator cuff tear (RCT). Reverse shoulder arthroplasty (RSA) may be a proper treatment for shoulder dysfunction and pain. This treatment that elevates shoulder movement has been augmented by recent advances in the development of the reverse shoulder prosthesis (RSP) design. The current review highlights the recent developments, revisions, and complications. The review of the published literature has been done to determine the overall rates of problems, complications, reoperations, and revisions after RSA. Furthermore, this review discusses the problems concerning RSP, shoulder joint replacement, and improvement in shoulder joint movement after arthroplasty. Ultimately, an outcome of different endeavors of the researcher was summarized. The endeavor of the current review indicates that RSA is a valuable alternative that can increase forward elevation, improve function, and relieve pain.

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Total shoulder replacement with a constrained prosthesis.

Cited by 93 publications

References 0 publications

The radiographic study in the relationship of the glenohumeral joint

The radiographic study in the relationship of the glenohumeral joint

Glenohumeral kinematics following total shoulder arthroplasty: A finite element investigation

A brief Review of Reverse Shoulder Prosthesis: Arthroplasty, Complications, Revisions, and Development

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