Terrier, J Bone Joint Surg Br 2008 - Simulated Joint and Muscle Forces in Reversed and Anatomic Shoulder Prostheses

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Simulated Joint and Muscle Forces in Reversed and Anatomic Shoulder Prostheses

Terrier, Farron, et al.·J Bone Joint Surg Br·2008·127 citations·Biomechanical study

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Reversed shoulder prostheses are increasingly being used for the treatment of glenohumeral arthropathy associated with a deficient rotator cuff. These non-anatomical implants attempt to balance the joint forces by means of a semi-constrained articular surface and a medialised centre of rotation. A finite element model was used to compare a reversed prosthesis with an anatomical implant. Active abduction was simulated from 0° to 150° of elevation. With the anatomical prosthesis, the joint force almost reached the equivalence of body weight. The joint force was half this for the reversed prosthesis. The direction of force was much more vertically aligned for the reverse prosthesis, in the first 90° of abduction. With the reversed prosthesis, abduction was possible without rotator cuff muscles and required 20% less deltoid force to achieve it. This force analysis confirms the potential mechanical advantage of reversed prostheses when rotator cuff muscles are deficient.

Copyright remains with the authors and publisher.

Simulated Joint and Muscle Forces in Reversed and Anatomic Shoulder Prostheses

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Simulated Joint and Muscle Forces in Reversed and Anatomic Shoulder Prostheses

Terrier, Farron, et al.·J Bone Joint Surg Br·2008·127 citations·Biomechanical study

|

Reversed shoulder prostheses are increasingly being used for the treatment of glenohumeral arthropathy associated with a deficient rotator cuff. These non-anatomical implants attempt to balance the joint forces by means of a semi-constrained articular surface and a medialised centre of rotation. A finite element model was used to compare a reversed prosthesis with an anatomical implant. Active abduction was simulated from 0° to 150° of elevation. With the anatomical prosthesis, the joint force almost reached the equivalence of body weight. The joint force was half this for the reversed prosthesis. The direction of force was much more vertically aligned for the reverse prosthesis, in the first 90° of abduction. With the reversed prosthesis, abduction was possible without rotator cuff muscles and required 20% less deltoid force to achieve it. This force analysis confirms the potential mechanical advantage of reversed prostheses when rotator cuff muscles are deficient.

Copyright remains with the authors and publisher.

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