Effect of Baseplate Positioning on Fixation of Reverse Total Shoulder Arthroplasty

Abstract

Background: The glenoid component in reverse total shoulder arthroplasty is recommended to be positioned inferiorly or with a downward tilt with the intention of reducing scapular notching. However, it is still unclear whether modifying the position of the glenoid prosthesis affects implant stability. The aim of this study was to determine the association between implant positioning and glenoid prosthesis fixation using Grammont reverse total shoulder arthroplasty. Methods: Four positions for the glenoid prosthesis were studied using the finite element method. The glenosphere was positioned as follows: 1) in the middle of the glenoid fossa, 2) flush with the inferior glenoid rim, 3) with an inferior overhang, 4) with a 15° inferior inclination. Bone-prosthesis micromotions and strain-induced bone adaptations were quantified during five daily activities. Findings: When the glenoid component was tilted inferiorly, the activities producing anterior-posterior shear forces (e.g. standing up from an armchair) caused an increase in peak micromotions. In the lateral-middle glenoid, inferior positioning caused a 64.6% reduction in bone apparent density. In the lateral-inferior glenoid, central positioning led to the most severe bone resorption, reaching 43.9%. Interpretation: Reducing activities which generate anterior-posterior shear forces on the shoulder joint will increase bone formation and may improve the primary stability of the implant when fixed in the position with an inferior tilt. Postoperative bone resorption is highly dependent on implant positioning. Understanding the relationship between bone resorption and implant positioning will help surgeons improve the long-term stability of reverse total shoulder arthroplasty.

Publication DOI: https://doi.org/10.1016/j.clinbiomech.2018.12.021
Divisions: College of Engineering & Physical Sciences > Aston Institute of Materials Research (AIMR)
College of Engineering & Physical Sciences
Additional Information: © 2018, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Uncontrolled Keywords: Bone remodelling,Fixation,Inferior position,Inferior tilt,Micromotion,Reverse total shoulder arthroplasty,Biophysics,Orthopedics and Sports Medicine
Publication ISSN: 0268-0033
Last Modified: 20 May 2024 07:26
Date Deposited: 07 Jan 2019 13:21
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Related URLs: https://www.sci ... 268003318307733 (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2019-02-01
Published Online Date: 2018-12-29
Accepted Date: 2018-12-20
Authors: Zhang, Min
Cheng-Kung, Cheng
Junaid, Sarah (ORCID Profile 0000-0001-9460-710X)
Gregory, Thomas
Hansen, Ulrich

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License: Creative Commons Attribution Non-commercial No Derivatives


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