Total shoulder arthroplasty: downward inclination of the glenoid component to balance supraspinatus deficiency.

Details

Serval ID
serval:BIB_7AD804DACA0E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Total shoulder arthroplasty: downward inclination of the glenoid component to balance supraspinatus deficiency.
Journal
Journal of Shoulder and Elbow Surgery
Author(s)
Terrier A., Merlini F., Pioletti D.P., Farron A.
ISSN
1532-6500[electronic]
Publication state
Published
Issued date
2009
Volume
18
Number
3
Pages
360-365
Language
english
Abstract
HYPOTHESIS: Supraspinatus deficiency associated with total shoulder arthroplasty (TSA) provokes eccentric loading and may induce loosening of the glenoid component. A downward inclination of the glenoid component has been proposed to balance supraspinatus deficiency.
METHODS: This hypothesis was assessed by a numeric musculoskeletal model of the glenohumeral joint during active abduction. Three cases were compared: TSA with normal muscular function, TSA with supraspinatus deficiency, and TSA with supraspinatus deficiency and downward inclination of the glenoid.
RESULTS: Supraspinatus deficiency increased humeral migration and eccentric loading. A downward inclination of the glenoid partly balanced the loss of stability, but this potential advantage was counterbalanced by an important stress increase within the glenoid cement. The additional subchondral bone reaming required to incline the glenoid component indeed reduced the bone support, increasing cement deformation and stress.
CONCLUSION: Glenoid inclination should not be obtained at the expense of subchondral bone support.
Keywords
Arthroplasty, Replacement/adverse effects, Arthroplasty, Replacement/methods, Biomechanics, Computer Simulation, Finite Element Analysis, Humans, Joint Instability/physiopathology, Joint Instability/prevention & control, Joint Prosthesis, Models, Anatomic, Muscle Contraction/physiology, Muscle, Skeletal/physiology, Prosthesis Design, Prosthesis Failure, Range of Motion, Articular/physiology, Sensitivity and Specificity, Shoulder Joint/physiopathology, Shoulder Joint/surgery, Stress, Mechanical
Pubmed
Web of science
Create date
18/01/2010 16:29
Last modification date
20/08/2019 14:36
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