Optimal positioning of the humeral component in the reverse shoulder prosthesis

被引：17

作者：

Nalbone L. ^{[1
]}

Adelfio R. ^{[1
]}

D'Arienzo M. ^{[1
]}

Ingrassia T. ^{[2
]}

Nigrelli V. ^{[2
]}

Zabbara F. ^{[2
]}

Paladini P. ^{[3
]}

Campi F. ^{[3
]}

Pellegrini A. ^{[3
]}

Porcellini G. ^{[3
]}

机构：

[1] Clinica Ortopedica e Traumatologica Del Policlinico, Paolo Giaccone Università Degli Studi di Palermo, Palermo

[2] Dipartimento di Ingegneria Chimica, Gestionale, Informatica, Meccanica, Università Degli Studi di Palermo, Palermo

[3] Unit of Shoulder and Elbow Surgery, Biomechanics Laboratory, D. Cervesi Hospital, 47841 Cattolica

来源：

MUSCULOSKELETAL SURGERY | 2014年 / 98卷 / 2期

关键词：

FEM analyses; Intrinsic stability; Polyethylene wear; Stability ratio; Total reverse shoulder arthroplasty;

D O I：

10.1007/s12306-013-0274-z

中图分类号：

学科分类号：

摘要：

Total reverse shoulder arthroplasty is becoming more and more the standard therapeutic practice for glenohumeral arthropathy with massive lesions of the rotator cuff. The biomechanical principle of this prosthesis is represented by the reversion of the normal anatomy of the shoulder joint. This non-anatomical prosthesis leads to a medialization of the rotation centre of the glenohumeral joint and also to a distalization of the humeral head. All that causes a deltoid tension increasing so allowing a larger abduction of the arm. Main complications of the reverse shoulder prosthesis are due to the joint instability, the scapular notching and the wear of the polyethylene insert. Purpose: The main goal of the present work is to study the effect of the positioning of the humeral component on the intrinsic stability of the reverse shoulder prosthesis. In particular, through finite element method simulations, the variation of the stability ratio of the shoulder joint has been calculated for both vertical and horizontal dislocating loads depending on the humeral stem version angle. Moreover, in order to estimate the wear of the polyethylene cup, some analyses have been developed to calculate the pressures on the polyethylene insert. Results: The obtained results demonstrate the dislocation of a shoulder prosthesis and the wear of the polyethylene insert can be prevented or limited by conveniently varying the version angle of the humeral component. © 2013 Istituto Ortopedico Rizzoli.

引用

页码：135 / 142

页数：7

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