Top

Published in:

Open Access 01-12-2019 | Research article

Influence of Glenosphere and baseplate parameters on Glenoid bone strains in reverse shoulder Arthroplasty

Authors: Leo Pauzenberger, Cory Dwyer, Elifho Obopilwe, Michael D. Nowak, Mark Cote, Anthony A. Romeo, Augustus D. Mazzocca, Felix Dyrna

Published in: BMC Musculoskeletal Disorders | Issue 1/2019

Abstract

Background

Little is known about the strains at the glenoid near the bone-implant interface in reverse shoulder arthroplasty. The purpose of the current study was to evaluate the strains on the glenoid bone under a compressive load after implantation of three different sizes of metal-backed baseplates in either inferior or superior position in combination with three different sizes of glenospheres and three different glenosphere designs.

Methods

Three sizes of baseplates (small, medium, large) were implanted in thirty-six paired human cadaveric scapulae either inferior, flush with the glenoid neck, or with a 5 mm superior offset. Glenospheres were available in three sizes (36 mm, 39 mm, 42 mm) and designs (standard, 4 mm lateralized, 2.5 mm inferiorized). Specimens were mounted in a servo-hydraulic testing apparatus at a 60° angle between the glenoid and actuator holding the humeral component. Four strain-gauge rosettes were placed around the glenoid rim to measure strains transferred to the scapular bone under a compressive load (750 N) relative to the various baseplate-glenosphere combinations. Following repeated compression, a load-to-failure test was performed.

Results

Mean overall registered strains were 161με (range: − 1165 to 2347) at the inferior sensor, −2με (range: − 213 to 90) at the superior sensor, −95με (range: − 381 to 254) at the anterior sensor, and 13με (range: − 298 to 128) at the posterior sensor. Measured bone strains did not show any significant differences across tested baseplate and glenosphere design, size, or positioning combinations (p > 0.05 for all sensors). Furthermore, linear regression analysis did not identify any of the evaluated parameters as an independent influential factor for strains (p > 0.05 for all sensors). Mean load-at-failure was significantly higher in the group of inferior (3347.0 N ± 704.4 N) compared to superior (2763.8 N ± 927.8 N) positioned baseplates (p = 0.046).

Conclusion

Different baseplate positions, baseplate sizes, glenosphere sizes, and glenosphere design or various combinations of these parameters did not significantly influence the measured bone strains at the glenoid near the bone-implant interface in a contemporary reverse shoulder arthroplasty system.

Level of evidence

Basic Science Study, Biomechanical Study.

Familiari F, Rojas J, Nedim Doral M, Huri G, McFarland EG. Reverse total shoulder arthroplasty. EFORT Open Rev. 2018;3(2):58–69. https://doi.org/10.1302/2058-5241.3.170044.CrossRefPubMedPubMedCentral

Sevivas N, Ferreira N, Andrade R, Moreira P, Portugal R, Alves D, et al. Reverse shoulder arthroplasty for irreparable massive rotator cuff tears: a systematic review with meta-analysis and meta-regression. J Shoulder Elb Surg. 2017;26(9):e265–77. https://doi.org/10.1016/j.jse.2017.03.039.CrossRef

Kazley JM, Cole KP, Desai KJ, Zonshayn S, Morse AS, Banerjee S. Prostheses for reverse total shoulder arthroplasty. Expert Rev Med Devices. 2019;16(2):107–18. https://doi.org/10.1080/17434440.2019.1568237.CrossRefPubMed

Zumstein MA, Pinedo M, Old J, Boileau P. Problems, complications, reoperations, and revisions in reverse total shoulder arthroplasty: a systematic review. J Shoulder Elb Surg. 2011;20(1):146–57. https://doi.org/10.1016/j.jse.2010.08.001.CrossRef

Mordecai SC, Lambert SM, Meswania JM, Blunn GW, Bayley IL, Taylor SJG. An experimental glenoid rim strain analysis for an improved reverse anatomy shoulder implant fixation. J Orthop Res. 2012;30(6):998–1003. https://doi.org/10.1002/jor.22015.CrossRefPubMed

Rubin CT, Lanyon LE. Regulation of bone formation by applied dynamic loads. J Bone Joint Surg Am. 1984;66(3):397–402.CrossRef

Rubin CT, McLeod KJ. Promotion of bony ingrowth by frequency-specific, low-amplitude mechanical strain. Clin Orthop Relat Res. 1994;298:165–74.

Ruimerman R, Van Rietbergen B, Hilbers P, Huiskes R. The effects of trabecular-bone loading variables on the surface signaling potential for bone remodeling and adaptation. Ann Biomed Eng. 2005;33(1):71–8.CrossRef

Frost HM. Perspectives: bone's mechanical usage windows. Bone Miner. 1992;19(3):257–71.CrossRef

10.

Flatow EL, Harrison AK. A history of reverse total shoulder arthroplasty. Clin Orthop Relat Res. 2011;469(9):2432–9. https://doi.org/10.1007/s11999-010-1733-6.CrossRefPubMedPubMedCentral

11.

Poppen NK, Walker PS. Forces at the glenohumeral joint in abduction. Clin Orthop Relat Res. 1978;135:165–70.

12.

Roche CP, Stroud NJ, Martin BL, Steiler CA, Flurin P-H, Wright TW, et al. The impact of scapular notching on reverse shoulder glenoid fixation. J Shoulder Elb Surg. 2013;22(7):963–70. https://doi.org/10.1016/j.jse.2012.10.035.CrossRef

13.

Harman M, Frankle M, Vasey M, Banks S. Initial glenoid component fixation in “reverse” total shoulder arthroplasty: a biomechanical evaluation. J Shoulder Elbow Surg. 2005;14(1 Suppl S):162S–7S. https://doi.org/10.1016/j.jse.2004.09.030.CrossRefPubMed

14.

Hoenig MP, Loeffler B, Brown S, Peindl R, Fleischli J, Connor P, et al. Reverse glenoid component fixation: is a posterior screw necessary? J Shoulder Elb Surg. 2010;19(4):544–9. https://doi.org/10.1016/j.jse.2009.10.006.CrossRef

15.

Hopkins AR, Hansen UN, Bull AMJ, Emery R, Amis AA. Fixation of the reversed shoulder prosthesis. J Shoulder Elb Surg. 2008;17(6):974–80. https://doi.org/10.1016/j.jse.2008.04.012.CrossRef

16.

Agresti A, Coull BA. Approximate is better than “exact” for interval estimation of binomial proportions. Am Stat. 1998;52(2):119–26. https://doi.org/10.1080/00031305.1998.10480550.CrossRef

17.

Mellal A, Wiskott HWA, Botsis J, Scherrer SS, Belser UC. Stimulating effect of implant loading on surrounding bone. Comparison of three numerical models and validation by in vivo data. Clin Oral Implants Res. 2004;15(2):239–48 Available from: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=15008937&retmode=ref&cmd=prlinks.CrossRef

18.

Mosley JR, Lanyon LE. Strain rate as a controlling influence on adaptive modeling in response to dynamic loading of the ulna in growing male rats. Bone. 1998;23(4):313–8 Available from: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=9763142&retmode=ref&cmd=prlinks.CrossRef

19.

Pattin CA, Caler WE, Carter DR. Cyclic mechanical property degradation during fatigue loading of cortical bone. J Biomech. 1996;29(1):69–79 Available from: https://linkinghub.elsevier.com/retrieve/pii/0021929094001561doi:10.1016/0021-9290(94)00156-1.CrossRef

20.

Brunski JB, Puleo DA, Nanci A. Biomaterials and biomechanics of oral and maxillofacial implants: current status and future developments. Int J Oral Maxillofac Implants. 2000;15(1):15–46.PubMed

21.

Holmes DC, Loftus JT. Influence of bone quality on stress distribution for endosseous implants. J Oral Implantol. 1997;23(3):104–11.PubMed

22.

Tada S, Stegaroiu R, Kitamura E, Miyakawa O, Kusakari H. Influence of implant design and bone quality on stress/strain distribution in bone around implants: a 3-dimensional finite element analysis. Int J Oral Maxillofac Implants. 2003;18(3):357–68.PubMed

23.

Hudieb M, Wakabayashi N, Suzuki T, Kasugai S. Morphologic classification and stress analysis of the mandibular bone in the premolar region for implant placement. Int J Oral Maxillofac Implants. 2010;25(3):482–90 Available from: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=20556246&retmode=ref&cmd=prlinks.PubMed

24.

Lévigne C, Boileau P, Favard L, Garaud P, Mole D, Sirveaux F, et al. Scapular notching in reverse shoulder arthroplasty. J Shoulder Elb Surg. 2008;17(6):925–35. https://doi.org/10.1016/j.jse.2008.02.010.CrossRef

25.

Nyffeler RW, Werner CML, Gerber C. Biomechanical relevance of glenoid component positioning in the reverse Delta III total shoulder prosthesis. J Shoulder Elb Surg. 2005;14(5):524–8. https://doi.org/10.1016/j.jse.2004.09.010.CrossRef

26.

Guery J, Favard L, Sirveaux F, Oudet D, Mole D, Walch G. Reverse total shoulder arthroplasty. Survivorship analysis of eighty replacements followed for five to ten years. J Bone Joint Surg Am. 2006;88(8):1742–7. https://doi.org/10.2106/JBJS.E.00851.CrossRefPubMed

Title: Influence of Glenosphere and baseplate parameters on Glenoid bone strains in reverse shoulder Arthroplasty
Authors: Leo Pauzenberger
Cory Dwyer
Elifho Obopilwe
Michael D. Nowak
Mark Cote
Anthony A. Romeo
Augustus D. Mazzocca
Felix Dyrna
Publication date: 01-12-2019
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2019
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-019-2968-3

ACC 2024 Congress

Springer Medicine

Influence of Glenosphere and baseplate parameters on Glenoid bone strains in reverse shoulder Arthroplasty

Abstract

Background

Methods

Results

Conclusion

Level of evidence

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Level of evidence

Please log in to get access to this content

Other articles of this Issue 1/2019

Management and outcome of pelvic fracture associated with vaginal injuries: a retrospective study of 25 cases

Psychosocial areas of worklife and chronic low back pain: a systematic review and meta-analysis

Clinical application of large channel endoscopic decompression in posterior cervical spine disorders

Musculoskeletal pains and cardiovascular autonomic function in the general Northern Finnish population

Finite element analysis comparison between superior clavicle locking plate with and without screw holes above fracture zone in midshaft clavicular fracture

Application of multiple wrapped cancellous bone graft methods for treatment of segmental bone defects