scholarly journals A Critical Review on Prosthetic Features Available for Reversed Total Shoulder Arthroplasty

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Bart Middernacht ◽  
Alexander Van Tongel ◽  
Lieven De Wilde
Keyword(s):  
Rotator Cuff ◽  
Critical Review ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Design Parameters ◽  
Patient Specific ◽  
Patient Specific Implants ◽  
Knowing That ◽  
Humeral Component ◽  
Rotator Cuff Arthropathy

Reversed total shoulder arthroplasty is a popular treatment in rotator cuff arthropathy and in displaced proximal humeral fractures in elderly. In 2016, 29 models of commercially available designs express this popularity. This study describes all the different design parameters available on the market. Prosthetic differences are found for the baseplate, glenosphere, polyethylene, and humeral component and these differences need to be weighed out carefully for each patient knowing that a gain in one mechanical parameter can balance the loss of another. Patient specific implants may help in the future.

Strain Analysis in the Scapula After a Reverse Total Shoulder Arthroplasty

2012 ◽  
Author(s):  
Radhika J. Patel ◽  
Chi Zhang ◽  
Yingxin Gao
Keyword(s):  
Articular Cartilage ◽  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Cartilage Damage ◽  
Strain Analysis ◽  
Reverse Total Shoulder Arthroplasty ◽  
Articular Cartilage Damage ◽  
Reverse Total Shoulder ◽  
Rotator Cuff Arthropathy

A reverse total shoulder arthroplasty (RTSA) is strongly suggested for patients who suffer from rotator cuff (RTC) arthropathy, where RTC deficiency causes abnormal loading leading to articular cartilage damage. Studies show that 47% of RTSA patients have rotator cuff arthropathy and 27% have some form of osteoarthritis (OA) [1].

scholarly journals Early migration of stemless and stemmed humeral components after total shoulder arthroplasty for osteoarthritis—study protocol for a randomized controlled trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Marc Randall Kristensen Nyring ◽  
Bo S. Olsen ◽  
Müjgan Yilmaz ◽  
Michael M. Petersen ◽  
Gunnar Flivik ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Controlled Trial ◽  
Total Shoulder Arthroplasty ◽  
Additional Patient ◽  
Randomized Controlled ◽  
Humeral Component ◽  
Patient Reported ◽  
Glenohumeral Osteoarthritis

Abstract Background Glenohumeral osteoarthritis can, in the most severe cases, require surgery with insertion of a shoulder arthroplasty. A design with a stem in the humeral bone canal is currently regarded as the standard treatment option in patients who have an intact rotator cuff function, but complications related to the stem including humeral fractures can have devastating consequences. By using a stemless humeral component, stem-related complications can be reduced. The aim of this study is to compare the Comprehensive Nano stemless total shoulder arthroplasty (intervention group) with the Comprehensive stemmed total shoulder arthroplasty (control group). Materials and methods This is a randomized controlled trial comparing the stemless and the stemmed total shoulder arthroplasty. All Danish citizens with glenohumeral osteoarthritis indicating a total shoulder arthroplasty referred to the orthopedic department at Copenhagen University Hospital in Herlev/Gentofte will be offered participation. The following exclude from participation: below 18 years of age, cognitive or linguistic impairment, insufficient function of the rotator cuff, poor bone quality, and ASA groups 4–5. A total of 122 patients will be included of which 56 will be part of a radiostereometric analysis (RSA) study of humeral component migration. The primary outcomes are magnitude of migration of the humeral component assessed by RSA and patient-reported outcome by Western Ontario Osteoarthritis of the Shoulder index (WOOS). The secondary outcomes are additional patient-reported outcomes, functional outcome, readmission, complications, revisions, and changes in bone mineral density (BMD) of the proximal humerus assessed by duel energy x-ray absorptiometry (DXA) and economy (cost-utility analysis). The patients are examined before the operation and 3, 6, 12, and 24 months postoperative. Discussion To our knowledge, RSA has never been used to access migration of a stemmed or a stemless humeral component nor has the stemmed and the stemless humeral component been compared with regard to pain relief and shoulder function in a randomized clinical trial. Today, the two designs are considered equal in the treatment of osteoarthritis. The study will provide surgeons and patients with information about shoulder arthroplasty for osteoarthritis and assist them in decision-making. Trial registration ClinicalTrials.gov NCT04105478. Registered on 25 September 2019

scholarly journals Anatomic humeral head replacement with a press-fit prosthesis: An in vivo radiographic study

2017 ◽  
Vol 9 (3) ◽  
Author(s):  
Bryan Vopat ◽  
Jeremy Truntzer ◽  
Daniel Aaron ◽  
Jack Anavian ◽  
Joel Schwartz ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Total Shoulder Arthroplasty ◽  
Anatomic Reconstruction ◽  
Implant Design ◽  
Design Parameters ◽  
Press Fit ◽  
Humeral Component ◽  
Glenohumeral Osteoarthritis ◽  
The Mean

Successful total shoulder arthroplasty is, in part, dependent on anatomic reconstruction of the glenohumeral joint. The purpose of this study was to evaluate the post-operative anatomy of total shoulder arthroplasty with an anatomic implant design in patients with primary glenohumeral osteoarthritis and compare it to published normative anatomic measurements. Fifty-one patients (56 shoulders) with primary glenohumeral osteoarthritis were treated with a press-fit humeral component as part of a total shoulder arthroplasty (Aequalis, Tornier, Edina, Minnesota). Analysis of postoperative true anterior posterior radiographs was performed with use of a custom software algorithm. The mean humeral inclination (head-shaft angle), mean humeral implant anatomical humeral axis, mean greater tuberosity height, and mean humeral head center offset (medial offset) were 135.4±5.1°, 1.73±1.7°, 6.9±2.4 mm, and 3.8±1.8 mm, respectively. All parameters were within the ranges reported in the literature for normal shoulders except the mean humeral head center offset, which was less than reported in the literature. Anatomic parameters of a total shoulder arthroplasty can be achieved with an anatomically designed, modular adaptable press-fit design. Reduced medial humeral head center offset was likely dependent upon implant specific design parameters.

Managing glenoid bone loss in total shoulder arthroplasty: Role of augmented patient-specific implants

2017 ◽  
Vol 28 (3) ◽  
pp. 134-139 ◽  
Author(s):  
Kyle A. Borque ◽  
Michelle J. Chang ◽  
Kathryn Welp ◽  
Eric R. Wagner ◽  
Jarret M. Woodmass ◽  
...  
Keyword(s):  
Bone Loss ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Glenoid Bone Loss ◽  
Patient Specific ◽  
Patient Specific Implants

scholarly journals Patient-specific Guides Using 3-dimensional Reconstruction Provide Accuracy and Reproducibility in Reverse Total Shoulder Arthroplasty

2019 ◽  
Vol 22 (1) ◽  
pp. 16-23
Author(s):  
Jong Pil Yoon ◽  
Dong Hyun Kim ◽  
Jae Wook Jung ◽  
Chang-Hwa Lee ◽  
Seunggi Min ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Conventional Group ◽  
Patient Specific ◽  
Glenoid Component ◽  
3 Dimensional ◽  
Humeral Component ◽  
Dimensional Reconstruction ◽  
Reverse Total Shoulder

Background: We aimed to evaluate whether the use of our novel patient-specific guide (PSG) with 3-dimensional reconstruction in reverse total shoulder arthroplasty (RTSA) would allow accurate and reliable implantation of the glenoid and humeral components.Methods: 20 fresh-frozen cadaveric shoulders were used. The PSG group (n=10) and conventional group (n=10) was evaluated the accuracy and reproducibility of implant positioning between before and after surgery on the computed tomography image.Results: The superoinferior and anteroposterior offset in the glenoid component were 0.42 ± 0.07, 0.50 ± 0.08 in the conventional group and 0.45 ± 0.03, 0.46 ± 0.02 in the PSG group. The inclination and version angles were -1.93° ± 4.31°, 2.27° ± 5.91° and 0.46° ± 0.02°, 3.38° ± 2.79°. The standard deviation showed a smaller difference in the PSG group. The anteroposterior and lateromedial humeral canal center offset in the humeral component were 0.45 ± 0.12, 0.48 ± 0.15 in the conventional group and 0.46 ± 0.59 (<i>p</i>=0.794), 0.46 ± 0.06 (<i>p</i>=0.702) in the PSG group. The PSG showed significantly better humeral stem alignment.Conclusions: The use of PSGs with 3-dimensional reconstruction reduces variabilities in glenoid and humerus component positions and prevents extreme positioning errors in RTSA.

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