Biomechanical comparison of 2 augmented glenoid designs: an integrated kinematic finite element analysis.
J Shoulder Elbow Surg
; 28(6): 1166-1174, 2019 Jun.
Article
en En
| MEDLINE
| ID: mdl-30876745
ABSTRACT
BACKGROUND:
Augmented glenoid implants are available to help restore the biomechanics of the glenohumeral joint with excessive retroversion. It is imperative to understand their behavior to make a knowledgeable preoperative decision. Therefore, our goal was to identify an optimal augmented glenoid design based on finite element analysis (FEA) under maximum physiological loading.METHODS:
FEA models of 2 augmented glenoid designs-wedge and step-were created per the manufacturers' specifications and virtually implanted in a scapula model to correct 20° of retroversion. Simulation of shoulder abduction was performed using the FEA shoulder model. The glenohumeral force ratio, relative micromotion, and stress levels on the cement mantle, glenoid vault, and backside of the implants were compared between the 2 designs.RESULTS:
The force ratio was 0.56 for the wedge design and 0.87 for the step design. Micromotion (combination of distraction, translation, and compression) was greater for the step design than the wedge design. Distraction measured 0.05 mm for the wedge design and 0.14 mm for the step component. Both implants showed a similar pattern for translation; however, compression was almost 3 times greater for the step component. Both implants showed high stress levels on the cement mantle. At the glenoid vault and on the implants, the stress levels were 1.65 MPa and 6.62 MPa, respectively, for the wedge design and 3.78 MPa and 13.25 MPa, respectively, for the step design.CONCLUSION:
Implant design slightly affects joint stability; however, it plays a major role regarding long-term survival. Overall, the augmented wedge design provides better implant fixation and stress profiles with less micromotion.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Diseño de Prótesis
/
Articulación del Hombro
/
Cavidad Glenoidea
/
Artroplastía de Reemplazo de Hombro
/
Prótesis de Hombro
Tipo de estudio:
Prognostic_studies
Límite:
Humans
/
Male
Idioma:
En
Revista:
J Shoulder Elbow Surg
Asunto de la revista:
ORTOPEDIA
Año:
2019
Tipo del documento:
Article