MUSCULOSKELETAL SURGERY

, Volume 98, Issue 2, pp 135–142 | Cite as

Optimal positioning of the humeral component in the reverse shoulder prosthesis

  • L. Nalbone
  • R. Adelfio
  • M. D’arienzo
  • T. Ingrassia
  • V. Nigrelli
  • F. Zabbara
  • P. Paladini
  • F. Campi
  • A. Pellegrini
  • G. Porcellini
Original Article
First Online:
Received:
Accepted:

Abstract

Introduction

Total reverse shoulder arthroplasty is becoming more and more the standard therapeutic practice for glenohumeral arthropathy with massive lesions of the rotator cuff. The biomechanical principle of this prosthesis is represented by the reversion of the normal anatomy of the shoulder joint. This non-anatomical prosthesis leads to a medialization of the rotation centre of the glenohumeral joint and also to a distalization of the humeral head. All that causes a deltoid tension increasing so allowing a larger abduction of the arm. Main complications of the reverse shoulder prosthesis are due to the joint instability, the scapular notching and the wear of the polyethylene insert.

Purpose

The main goal of the present work is to study the effect of the positioning of the humeral component on the intrinsic stability of the reverse shoulder prosthesis. In particular, through finite element method simulations, the variation of the stability ratio of the shoulder joint has been calculated for both vertical and horizontal dislocating loads depending on the humeral stem version angle. Moreover, in order to estimate the wear of the polyethylene cup, some analyses have been developed to calculate the pressures on the polyethylene insert.

Results

The obtained results demonstrate the dislocation of a shoulder prosthesis and the wear of the polyethylene insert can be prevented or limited by conveniently varying the version angle of the humeral component.

Keywords

Total reverse shoulder arthroplasty Intrinsic stability FEM analyses Polyethylene wear Stability ratio 
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Notes

Conflict of interest

None.

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Copyright information

© Istituto Ortopedico Rizzoli 2013

Authors and Affiliations

  • L. Nalbone
    • 1
  • R. Adelfio
    • 1
  • M. D’arienzo
    • 1
  • T. Ingrassia
    • 2
  • V. Nigrelli
    • 2
  • F. Zabbara
    • 2
  • P. Paladini
    • 3
  • F. Campi
    • 3
  • A. Pellegrini
    • 3
  • G. Porcellini
    • 3
  1. 1.Clinica Ortopedica e Traumatologica del Policlinico‘Paolo Giaccone’ Università degli Studi di PalermoPalermoItaly
  2. 2.Dipartimento di Ingegneria Chimica, Gestionale, Informatica, MeccanicaUniversità degli Studi di PalermoPalermoItaly
  3. 3.Unit of Shoulder and Elbow Surgery, Biomechanics Laboratory“D. Cervesi” HospitalCattolicaItaly

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