As the number of reverse shoulder arthroplasty (RSA) procedures increases, so does the incidence of revision surgery. Baseplate-related complications account for the highest proportion of these revisions, and it has been reported that improving baseplate fixation reduces the likelihood of failure. The present study aims to evaluate the initial stability of the baseplate to the glenoid after RSA. A finite element analysis (FEA) was performed using LS-DYNA models of the scapula and the SMR shoulder system, with a load of 30 N applied in both abduction and flexion, using the baseplate implantation surface as the reference. Micromotion was defined as the difference in displacement between the baseplate and the scapular fossa. The results demonstrated that micromotion between the glenoid and the baseplate diminished with increasing elevation in both abduction and flexion. It is hypothesised that in the SMR shoulder system, the screws are pressed into the glenoid during abduction, thereby contributing to enhanced initial stability.
References
[1]
Parada, S.A., Flurin, P., Wright, T.W., Zuckerman, J.D., Elwell, J.A., Roche, C.P., et al. (2021) Comparison of Complication Types and Rates Associated with Anatomic and Reverse Total Shoulder Arthroplasty. JournalofShoulderandElbowSurgery, 30, 811-818. https://doi.org/10.1016/j.jse.2020.07.028
[2]
Stephens, B.C., Simon, P., Clark, R.E., Christmas, K.N., Stone, G.P., Lorenzetti, A.J., et al. (2016) Revision for a Failed Reverse: A 12-Year Review of a Lateralized Implant. JournalofShoulderandElbowSurgery, 25, e115-e124. https://doi.org/10.1016/j.jse.2015.09.027
[3]
Bonnevialle, N., Geais, L., Müller, J.H. and Berhouet, J. (2020) Effect of RSA Glenoid Baseplate Central Fixation on Micromotion and Bone Stress. JSESInternational, 4, 979-986. https://doi.org/10.1016/j.jseint.2020.07.004
[4]
Hopkins, A.R., Hansen, U.N., Bull, A.M.J., Emery, R. and Amis, A.A. (2008) Fixation of the Reversed Shoulder Prosthesis. JournalofShoulderandElbowSurgery, 17, 974-980. https://doi.org/10.1016/j.jse.2008.04.012
[5]
Zhang, M., Junaid, S., Gregory, T., Hansen, U. and Cheng, C. (2019) Effect of Baseplate Positioning on Fixation of Reverse Total Shoulder Arthroplasty. ClinicalBiomechanics, 62, 15-22. https://doi.org/10.1016/j.clinbiomech.2018.12.021
[6]
Boileau, P., Watkinson, D.J., Hatzidakis, A.M. and Balg, F. (2005) Grammont Reverse Prosthesis: Design, Rationale, and Biomechanics. JournalofShoulderandElbowSurgery, 14, S147-S161. https://doi.org/10.1016/j.jse.2004.10.006
[7]
Ackland, D.C., Patel, M. and Knox, D. (2015) Prosthesis Design and Placement in Reverse Total Shoulder Arthroplasty. JournalofOrthopaedicSurgeryandResearch, 10, Article No. 101. https://doi.org/10.1186/s13018-015-0244-2
[8]
Farron, A., Terrier, A. and Büchler, P. (2006) Risks of Loosening of a Prosthetic Glenoid Implanted in Retroversion. JournalofShoulderandElbowSurgery, 15, 521-526. https://doi.org/10.1016/j.jse.2005.10.003
[9]
Friedman, R.J., Sun, S., She, X., Esposito, J., Eichinger, J.K. and Yao, H. (2021) Effects of Increased Retroversion Angle on Glenoid Baseplate Fixation in Reverse Total Shoulder Arthroplasty: A Finite Element Analysis. SeminarsinArthroplasty: JSES, 31, 209-216. https://doi.org/10.1053/j.sart.2020.11.014
[10]
Sanjay, G. and Prosenjit, D. (2004) Bone Geometry and Mechanical Properties of the Human Scapula Using Computed Tomography Data. Trends in Biomaterials and Artificial Organs, 17, 61-69.
[11]
Bayraktar, H.H., Morgan, E.F., Niebur, G.L., Morris, G.E., Wong, E.K. and Keaveny, T.M. (2004) Comparison of the Elastic and Yield Properties of Human Femoral Trabecular and Cortical Bone Tissue. JournalofBiomechanics, 37, 27-35. https://doi.org/10.1016/s0021-9290(03)00257-4
[12]
Denard, P.J., Lederman, E., Parsons, B.O. and Romeo, A.A. (2016) Finite Element Analysis of Glenoid-Sided Lateralization in Reverse Shoulder Arthroplasty. JournalofOrthopaedicResearch, 35, 1548-1555. https://doi.org/10.1002/jor.23394
[13]
Zhang, M., Junaid, S., Gregory, T., Hansen, U. and Cheng, C. (2020) Impact of Scapular Notching on Glenoid Fixation in Reverse Total Shoulder Arthroplasty: An in Vitro and Finite Element Study. JournalofShoulderandElbowSurgery, 29, 1981-1991. https://doi.org/10.1016/j.jse.2020.01.087
[14]
Poon, P.C., Chou, J., Young, D., Malak, S.F. and Anderson, I.A. (2010) Biomechanical Evaluation of Different Designs of Glenospheres in the SMR Reverse Shoulder Prosthesis: Micromotion of the Baseplate and Risk of Loosening. Shoulder&Elbow, 2, 94-99. https://doi.org/10.1111/j.1758-5740.2010.00059.x