AI Article Synopsis
- This study investigates a wedged glenoid component designed to correct retroverted glenoid deformities and reduce stress on the implant, cement, and bone.
- The research uses computational models to compare standard components in both retroverted and neutral alignments against the wedged design under simulated in vivo conditions.
- Results show that the wedged glenoid component significantly lessens stress and enhances fatigue life, making it a promising alternative to traditional correction methods like eccentric reaming and bone grafting.
Article Abstract
Background: This study undertook a computational analysis of a wedged glenoid component for correction of retroverted glenoid arthritic deformity to determine whether a wedge-shaped glenoid component design with a built-in correction for version reduces excessive stresses in the implant, cement, and glenoid bone. Recommendations for correcting retroversion deformity are asymmetric reaming of the anterior glenoid, bone grafting of the posterior glenoid, or a glenoid component with posterior augmentation. Eccentric reaming has the disadvantages of removing normal bone, reducing structural support for the glenoid component, and increasing the risk of bone perforation by the fixation pegs. Bone grafting to correct retroverted deformity does not consistently generate successful results.
Methods: Finite element models of 2 scapulae models representing a normal and an arthritic retroverted glenoid were implanted with a standard glenoid component (in retroversion or neutral alignment) or a wedged component. Glenohumeral forces representing in vivo loading were applied and stresses and strains computed in the bone, cement, and glenoid component.
Results: The retroverted glenoid components generated the highest compressive stresses and decreased cyclic fatigue life predictions for trabecular bone. Correction of retroversion by the wedged glenoid component significantly decreased stresses and predicted greater bone fatigue life. The cement volume estimated to survive 10 million cycles was the lowest for the retroverted components and the highest for neutrally implanted glenoid components and for wedged components.
Conclusion: A wedged glenoid implant is a viable option to correct severe arthritic retroversion, reducing the need for eccentric reaming and the risk for implant failure.
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| http://dx.doi.org/10.1016/j.jse.2013.06.008 | DOI Listing |
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