Biomechanical benefits of anterior offsetting of humeral head component in posteriorly unstable total shoulder arthroplasty: A cadaveric study

Hyun Min Mike Kim, Alexander C. Chacon, Seth H. Andrews, Evan P. Roush, Edward Cho, William K. Conaway, Allen R. Kunselman, Gregory S. Lewis

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Restoration of joint stability during total shoulder arthroplasty can be challenging in the face of severe glenoid retroversion. A novel technique of humeral head component anterior-offsetting has been proposed to address posterior instability. We evaluated the biomechanical benefits of this technique in cadaveric specimens. Total shoulder arthroplasty was performed in 14 cadaveric shoulders from 7 donors. Complementary shoulders were assigned to either 10° or 20° glenoid retroversion, with retroversion created by eccentric reaming. Two humeral head component offset positions were tested in each specimen: The anatomic (posterior) and anterior (reverse). With loads applied to the rotator cuff and deltoid, joint contact pressures and the force and energy required for posterior humeral head translation were measured. The force and energy required to displace the humeral head posteriorly increased significantly with the anterior offset position compared to the anatomic offset position. The joint contact pressures were significantly shifted anteriorly, and the joint contact area significantly increased with the anterior offset position. Anterior offsetting of the humeral head component increased the resistance to posterior humeral head translation, shifted joint contact pressures anteriorly, and increased joint contact area, thus, potentially increasing the joint stability in total shoulder arthroplasty with simulated glenoid retroversion.

Original languageEnglish (US)
Pages (from-to)666-674
Number of pages9
JournalJournal of Orthopaedic Research
Volume34
Issue number4
DOIs
StatePublished - Apr 1 2016

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Humeral Head
Arthroplasty
Joints
Pressure
Rotator Cuff

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine

Cite this

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title = "Biomechanical benefits of anterior offsetting of humeral head component in posteriorly unstable total shoulder arthroplasty: A cadaveric study",
abstract = "Restoration of joint stability during total shoulder arthroplasty can be challenging in the face of severe glenoid retroversion. A novel technique of humeral head component anterior-offsetting has been proposed to address posterior instability. We evaluated the biomechanical benefits of this technique in cadaveric specimens. Total shoulder arthroplasty was performed in 14 cadaveric shoulders from 7 donors. Complementary shoulders were assigned to either 10° or 20° glenoid retroversion, with retroversion created by eccentric reaming. Two humeral head component offset positions were tested in each specimen: The anatomic (posterior) and anterior (reverse). With loads applied to the rotator cuff and deltoid, joint contact pressures and the force and energy required for posterior humeral head translation were measured. The force and energy required to displace the humeral head posteriorly increased significantly with the anterior offset position compared to the anatomic offset position. The joint contact pressures were significantly shifted anteriorly, and the joint contact area significantly increased with the anterior offset position. Anterior offsetting of the humeral head component increased the resistance to posterior humeral head translation, shifted joint contact pressures anteriorly, and increased joint contact area, thus, potentially increasing the joint stability in total shoulder arthroplasty with simulated glenoid retroversion.",
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Biomechanical benefits of anterior offsetting of humeral head component in posteriorly unstable total shoulder arthroplasty : A cadaveric study. / Kim, Hyun Min Mike; Chacon, Alexander C.; Andrews, Seth H.; Roush, Evan P.; Cho, Edward; Conaway, William K.; Kunselman, Allen R.; Lewis, Gregory S.

In: Journal of Orthopaedic Research, Vol. 34, No. 4, 01.04.2016, p. 666-674.

Research output: Contribution to journalArticle

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