Cement stress predictions after anatomic total shoulder arthroplasty are correlated with preoperative glenoid bone quality.

Détails

ID Serval
serval:BIB_708765C7CF4A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Cement stress predictions after anatomic total shoulder arthroplasty are correlated with preoperative glenoid bone quality.
Périodique
Journal of shoulder and elbow surgery
Auteur(s)
Terrier A., Obrist R., Becce F., Farron A.
ISSN
1532-6500 (Electronic)
ISSN-L
1058-2746
Statut éditorial
Publié
Date de publication
09/2017
Peer-reviewed
Oui
Volume
26
Numéro
9
Pages
1644-1652
Langue
anglais
Notes
Publication types: Evaluation Studies ; Journal Article
Publication Status: ppublish
Résumé
We hypothesized that biomechanical parameters typically associated with glenoid implant failure after anatomic total shoulder arthroplasty (aTSA) would be correlated with preoperative glenoid bone quality.
We developed an objective automated method to quantify preoperative glenoid bone quality in different volumes of interest (VOIs): cortical bone, subchondral cortical plate, subchondral bone after reaming, subchondral trabecular bone, and successive layers of trabecular bone. Average computed tomography (CT) numbers (in Hounsfield units [HU]) were measured in each VOI from preoperative CT scans. In parallel, we built patient-specific finite element models of simulated aTSAs to predict cement stress, bone-cement interfacial stress, and bone strain around the glenoid implant. CT measurements and finite element predictions were obtained for 20 patients undergoing aTSA for primary glenohumeral osteoarthritis. We tested all linear correlations between preoperative patient characteristics (age, sex, height, weight, glenoid bone quality) and biomechanical predictions (cement stress, bone-cement interfacial stress, bone strain).
Average CT numbers gradually decreased from cortical (717 HU) to subchondral and trabecular (362 HU) bone. Peak cement stress (4-10 MPa) was located within the keel hole, above the keel, or behind the glenoid implant backside. Cement stress, bone-cement interfacial stress, and bone strain were strongly negatively correlated with preoperative glenoid bone quality, particularly in VOIs behind the implant backside (subchondral trabecular bone) but also in deeper trabecular VOIs.
Our numerical study suggests that preoperative glenoid bone quality is an important parameter to consider in aTSA, which may be associated with aseptic loosening of the glenoid implant. These initial results should now be confronted with clinical and radiologic outcomes.

Mots-clé
Aged, Aged, 80 and over, Arthroplasty, Replacement, Shoulder, Bone Cements/adverse effects, Female, Finite Element Analysis, Glenoid Cavity/diagnostic imaging, Humans, Male, Middle Aged, Predictive Value of Tests, Preoperative Period, Prosthesis Failure, Stress, Mechanical, Tomography, X-Ray Computed, Anatomic total shoulder arthroplasty, cement, computed tomography, finite element, glenoid bone quality, stress
Pubmed
Web of science
Création de la notice
22/08/2017 11:00
Dernière modification de la notice
20/08/2019 14:29
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