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Journal of Orthopaedic Surgery and Research

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Open Access 01-12-2024 | Methodology

Time-elapsed microstructural imaging of failure of the reverse shoulder implant

Authors: Saulo Martelli, Egon Perilli, Xiaolong Fan, Sophie Rapagna, Ashish Gupta

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2024

Abstract

Background

Reverse Shoulder Arthroplasties (RSA) have become a primary choice for improving shoulder function and pain. However, the biomechanical failure mechanism of the humeral component is still unclear. The present study reports a novel protocol for microstructural imaging of the entire humerus implant under load before and after fracture.

Methods

A humerus specimen was obtained from a 75-year-old male donor. An expert surgeon implanted the specimen with a commonly used RSA implant (Aequalis reversed II, Stryker Orthopaedics, USA) and surgical procedure. The physiological glenohumeral contact force that maximized the distal implant migration was selected from a public repository (orthoload.com). Imaging and concomitant mechanical testing were performed using a large-volume micro-CT scanner (Nikon XT H 225 ST) and a custom-made compressive stage. Both when intact and once implanted, the specimen was tested under a pre-load and by imposing a constant deformation causing a physiological reaction load (650 N, 10 degrees adducted). The deformation of the implanted specimen was then increased up to fracture, which was identified by a sudden drop of the reaction force, and the specimen was then re-scanned.

Results

The specimen’s stiffness decreased from 874 N/mm to 464 N/mm after implantation, producing movements of the bone-implant interface consistent with the implant’s long-term stability reported in the literature. The micro-CT images displayed fracture of the tuberosity, caused by a combined compression and circumferential tension, induced by the distal migration of the implant.

Conclusion

The developed protocol offers detailed information on implant mechanics under load relative to intact conditions and fracture, providing insights into the failure mechanics of RSA implants. This protocol can be used to inform future implant design and surgical technique improvements.

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Title: Time-elapsed microstructural imaging of failure of the reverse shoulder implant
Authors: Saulo Martelli
Egon Perilli
Xiaolong Fan
Sophie Rapagna
Ashish Gupta
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2024
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-024-04652-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Time-elapsed microstructural imaging of failure of the reverse shoulder implant

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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