Pre-operative planning for reverse shoulder arthroplasty in low-resource centres: A modified Delphi study in South Africa.

Background: Pre-operative planning for reverse shoulder arthroplasty (RSA) poses challenges, particularly when dealing with glenoid bone loss. This modified Delphi study aimed to assess expert consensus on RSA planning processes and rationale, specifically targeting low-resourced institutions. Our objective was to offer pre-operative decision-making algorithms tailored for surgeons practising in resource-constrained hospitals with limited access to computed tomography (CT) scans.

Moment arms of the coracobrachialis and short head of biceps following a Latarjet procedure: a modeling study.

Background: The Latarjet procedure transfers the coracoid process to the anterior glenoid. This prevents recurrent anterior humeral dislocation but alters the origins of the coracobrachialis (CBR) and short head of the biceps (SHB). The impact of this alteration on the moment arms of these muscles has not been examined.

A narrative review of treatment strategies for major glenoid defects during primary reverse shoulder arthroplasty, with a focus on the use of structural bone graft.

Structural glenoid defects are common during primary reverse shoulder arthroplasty (RSA) and are often associated with poor outcomes. The lack of pre-operative imaging protocols for determining the depth and degree of glenoid wear hinders our ability to accurately plan and correct these defects. Although bone grafting has been reported to be effective in reducing glenoid wear during RSA, there is limited information on when to utilise it and how to prepare the graft.

Characterizing moment arms of the coracobrachialis and short head of biceps in native shoulders and after reverse total shoulder arthroplasty during elevation and rotation: a modeling study.

Background: Reverse total shoulder arthroplasty (RTSA) alters the line of action of muscles around the glenohumeral joint. The effects of these changes have been well characterized for the deltoid, but there is limited information regarding the biomechanical changes to the coracobrachialis (CBR) and short head of biceps (SHB). In this biomechanical study, we investigated the changes to the moment arms of the CBR and SHB due to RTSA using a computational model of the shoulder.

Development of a framework to assess the biomechanical impact of reverse shoulder arthroplasty placement modifications.

Reverse shoulder arthroplasty biomechanics can be improved by modifying the placement of prosthesis. Biomechanical studies have quantified the impact of placement modifications on the mobility and stability of the reverse shoulder. While these studies have provided detailed insights, direct comparisons between their finding are obfuscated by their use of differing methodologies.

Identification of recurring scapular fracture patterns using 3-dimensional computerized fracture mapping.

Background: Scapular fracture fixation and implant selection are guided by the fracture pattern and classification, which requires accurate understanding and interpretation of the fracture lines. Three-dimensional (3D) computed tomography (CT)-based fracture pattern analysis enhances a more accurate understanding of the scapular fracture patterns. The purpose of this study was to create scapular fracture maps and identify the frequent fracture patterns using 3D reconstructed CT images.

Quantitative fit analysis of acromion fracture plating systems using three-dimensional reconstructed scapula fractures - A multi-observer study.

Introduction: Surgical treatment of displaced acromial and scapula spine fractures may be challenging due to the bony anatomy and variable fracture patterns. This difficulty is accentuated by the limitations of the available scapular plates for fracture fixation. This study compares the quantitative fitting of anatomic scapular plates and clavicle plates, using three-dimensional (3D) printed fractured scapulae.

A Randomized Controlled Trial of Eccentric Versus Concentric Cycling for Anterior Cruciate Ligament Reconstruction Rehabilitation.

Background: Persistent strength and biomechanical deviations remain after anterior cruciate ligament reconstruction (ACLR). Eccentric training may reduce these and associated reinjury or osteoarthritis risks.

Hypothesis: For male patients who have undergone ACLR, eccentric training is more effective than concentric training at improving knee flexion angle and other biomechanical deviations, as well as strength and patient-reported outcomes, using a matched perceived exertion dose.

Influence of Different Connecting Rod Configurations on the Stability of the Ilizarov/TSF Frame: A Biomechanical Study.

Aim: The Ilizarov external fixator (IEF) is frequently used in trauma and elective orthopaedics. Many of its biomechanical variables (ring size, wire diameter, wire number, half pins vs wires, etc.) and their influence on stability and stiffness have been investigated.

An interpopulation comparison of 3-dimensional morphometric measurements of the proximal humerus.

Background: Precise anatomic reconstruction of the proximal humerus is essential to a favorable outcome of total shoulder arthroplasty. Because of the wide variation in the geometric features of the proximal humerus, prosthetic designs incorporating these disparities are being developed.

Methods: The aim of this study is to use data obtained from cadavers and computed tomographic scans to investigate the 3-dimensional morphometric parameters of the proximal humerus of South African and Swiss samples and make an interpopulation comparison.

Diagnostics as the Key to Advances in Global Health: Proposed Methods for Making Reliable Diagnostics Widely Available.

This paper proposes a structure and method for the development of an AI diagnostic system as a highly leveraged step toward improvements in delivery of healthcare in underserved regions. First, the paper provides a high-level, general review of the current efforts to provide healthcare services in underserved areas and the many efforts being made to impact health outcomes by various international, governmental, and NGO entities. We also very briefly review university programs and research institutions that have specific technical and institutional assets with significant potential to carry out research or to partially implement such a plan.

Effect of humeral tray placement on impingement-free range of motion and muscle moment arms in reverse shoulder arthroplasty.

Background: It has been suggested that onlay humeral tray placement in reverse shoulder arthroplasty can affect impingement and muscle functionality. This study investigates biomechanical changes to the reversed shoulder using a variety of tray positional configurations.

Methods: The reconstructed scapula and humerus from 12 CT scans were used to customise a 3D biomechanical model of the shoulder.

Anatomic variations in glenohumeral joint: an interpopulation study.

Background: This study focused on the unique aspect of investigating shoulder morphometric differences between 2 distinct populations.

Methods: We used 90 computed tomography images of cadaveric shoulders for this study; 45 scans belonged to the South African (SA) cohort (49.74 ± 15.

Open source modular ptosis crutch for the treatment of myasthenia gravis.

Introduction: Pharmacologic treatment of Myasthenia Gravis presents challenges due to poor tolerability in some patients. Conventional ptosis crutches have limitations such as interference with blinking which causes ocular surface drying, and frequent irritation of the eyes. To address this problem, a modular and adjustable ptosis crutch for elevating the upper eyelid in Myasthenia Gravis patients has been proposed as a non-surgical and low-cost solution.

Subject-specific shoulder muscle attachment region prediction using statistical shape models: A validity study.

Subject-specific musculoskeletal models can predict accurate joint and muscle biomechanics thereby helping clinicians and surgeons. Current modeling strategies do not incorporate accurate subject-specific muscle parameters. This study reports a statistical shape model (SSM) based method to predict subject-specific muscle attachment regions on shoulder bones and illustrates the concurrent validity of the predictions.

Assessment of 3D morphological characteristics of the shoulder bones using statistical shape modeling: Prospective application to handedness.

In this study we have described the use of statistical shape modeling (SSM) technique in evaluating the morphological variation of shoulder bones from a South African population. The anatomical landmark selections were carried out, followed by the registration of the meshes which were validated before establishing the dense correspondence. The SSMs were built and average shape comparison from each side for each bone were made in order to evaluate handedness.

Kinematic and kinetic gait deviations in males long after anterior cruciate ligament reconstruction.

Background: Biomechanical deviations long (approx. 5years) after anterior cruciate ligament reconstruction have not been quantified in males, despite their distinct risk profile as compared to females. These deviations can indicate altered joint loading during chronic, repetitive motions.

Finite element model-based evaluation of tissue stress variations to fabricate corrective orthosis in feet with neutral subtalar joint.

Background: The subtalar joint position during static stance is a crucial determinant of the peak plantar pressures and forms ideal reference point for any intervention in foot-related problems for leprosy-affected patients.

Objectives: The study pursued the hypothesis through a three-dimensional model that stress will be minimal in the distal joints of the foot when the subtalar joint is in neutral static stance position.

Study Design: Finite element model.

Femoral neck anteversion measurement using linear slot scanning radiography.

Measurements between anatomical landmarks on radiographs are useful for diagnosis and treatment planning in the orthopedic field. Direct measurement on single radiographic images, however, does not truly reflect spatial relationships, as depth information is lost. We used stereo images from a slot scanning X-ray machine to estimate coordinates of three-dimensional (3D) bony landmarks for femoral neck anteversion (FNA) measurement.

Design of mechanical interface to re-distribute excess pressure to prevent the formation of decubitus ulcers in bed ridden patients.

Pressure ulcers are the major problem in the stroke management and rehabilitation. Prevention of pressure ulcer is of keen interest and is achieved by frequently changing the position of patient on the mattress. However, the care needs to be intensive to address this issue; else it would lead to pressure ulcer or bed sores formation.

Novel approach for designing a low weight hip implant used in total hip arthroplasty adopting skeletal design techniques.

Aseptic loosening is the major cause of failure of hip implants after total hip arthroplasty. Stress shielding of the femur is known to be the principal factor involved in the aseptic loosening of hip implants. Solid stems are found to have a greater rigidity; therefore, they transfer less load proximally, which results in greater stress shielding of the proximal femur.

Design optimization of skeletal hip implant cross-sections using finite-element analysis.

The major causes for revision surgery after total hip arthroplasty are aseptic loosening, dislocation, wear, design factors, stress shielding on the bone, and mechanical and biological factors. A material with toughness and high wear properties is essential for a good hip implant because these implants fail due to design. Stress shielding is found to be the major cause for the failure of hip implants, and can lead to the implant needing to be replaced or revised, which is painful for the patient and costly for the health care industry.

Biomechanical evaluation of degree of freedom of movements of a novel high-flexion knee for its suitability in eastern lifestyles.

The total knee arthroplasty is the end-stage surgical procedure for pain relief in degenerative diseases such as arthritis. There have been many models designed in the five to six decades of arthroplasty history. This research has helped us in designing a new artificial high-flexion knee, which emphasizes a high flexion-extension range of over 125 degrees.

Techniques in the development of a lower weight medical implants and strength validation using finite element methods.

Artificial knees have been used in total knee arthroplasty for more than 6 decades. The major drawback of the medical implant is its weight, with the average weight of an artificial knee implant made of stainless steel and ultra-high-molecular-weight polyethylene being approximately 450 g. Tne weight of the natural knee removed during arthroplasty is < 70 g.

Artificial knee implant design parameters affecting the range of motion improvement after total knee arthroplasty.

Total knee arthroplasty is a surgical procedure that is commonly used for pain relief and movement restoration in cases of severe arthritis. The knee implant design plays a vital role in determining patients' activity levels after total knee replacement. Of the 90 percent of younger patients who undergo knee replacement surgeries, restriction is caused by the implant design.