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Biomechanical evaluation of different designs of glenospheres in the SMR reverse total shoulder prosthesis: range of motion and risk of scapular notching. | LitMetric

AI Article Synopsis

  • Reverse total shoulder arthroplasty is a treatment for cuff tear arthropathy, but scapular notching is a potential issue that this study addresses.
  • The study examined four designs of glenospheres (standard and eccentric, both in 36 mm and 44 mm sizes) to see how they affect the range-of-motion during shoulder movement.
  • The results indicated that eccentric glenospheres, especially those with a larger diameter, significantly improve the range of motion in shoulder adduction, which could help reduce the risk of scapular notching.

Article Abstract

Background: Reverse total shoulder arthroplasty is a treatment option for cuff tear arthropathy. Scapular notching remains a concern. This biomechanical study compared the range-of-motion in different designs of glenospheres and hence the relative risk of scapular notching.

Method: A precision coordinate device was used to investigate four different designs of glenospheres (SMR prosthesis); 36 mm concentric (Standard), 36 mm eccentric, 44 mm concentric, and 44 mm eccentric glenospheres. The centre of rotation in each design was first established. The position of the humeral prosthesis was recorded in the plane of the scapula to compare the degree of adduction and the total range-of-motion.

Results: Eccentric glenospheres were found to improve range-of-motion by allowing a higher degree of adduction. Larger diameter glenospheres were found to improve range-of-motion by increasing adduction and abduction. Compared to the 36 mm concentric (standard) glenosphere, the 36 mm eccentric glenosphere improved adduction by 14.5 degrees, the 44 mm concentric glenosphere improved adduction by 11.6 degrees, the 44 mm eccentric glenosphere improved adduction by 17.7 degrees.

Conclusion: Eccentric glenospheres with a center-of-rotation placed more inferiorly were shown to improve adduction. This design may reduce the clinical incidence of scapular notching.

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Source
http://dx.doi.org/10.1016/j.jse.2009.01.015DOI Listing

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