Abstract
The glenohumeral joint is the most mobile joint in the human body. The stability of the joint is provided by a combination of both static and dynamic factors. The bones, the ligaments, and the capsule represent the static stabilizers. The ligamento-capsular complex is crucial to the end range of motion when they are stretched [1]. The rotator cuff muscles are m. supraspinatus, m. infraspinatus, m. teres minor, and m. subscapularis and are the dynamic stabilizers. They provide “contraction-compression” model of stability [2]. The contraction both centers the head and compresses it against the glenoid fossa. They are most effective in the mid- and end-range of motion. Their action is best described as stability by balancing the force couples. Infraspinatus, teres minor, and subscapularis provide a net inferiorly directed force; deltoid muscle provides a net superiorly directed force resulting in net force balance in coronal plane. In the analogous manner, subscapularis is balancing infraspinatus and teres minor muscles in sagittal plane [3]. The rotator cuff actively stabilizes and opposes upward motion of the humeral head during contraction of the deltoid muscle.
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References
Lee SB, Kim KJ, O’Driscoll SW, Morrey BF, An KN. Dynamic glenohumeral stability provided by the rotator cuff muscles in the mid-range and end-range of motion: a study in cadavera. J Bone Joint Surg Am. 2000;82(6):849–57.
Lippitt S, Matsen F. Mechanisms of glenohumeral joint stability. Clin Orthop Relat Res. 1993;(291):20–8. http://www.ncbi.nlm.nih.gov/pubmed/8504601.
Burkhart SS. Fluoroscopic comparison of kinematic patterns in massive rotator cuff tears: a suspension bridge model. Clin Orthop Relat Res. 1992;284(284):144–52.
Dines DM, Moynihan DP, Dines J, McCann P. Irreparable rotator cuff tears: what to do and when to do it; the surgeon’s dilemma. J Bone Joint Surg Am. 2006;88(10):2294–302. http://www.ncbi.nlm.nih.gov/pubmed/17472288, http://www.ncbi.nlm.nih.gov/pubmed/17066569.
Neer CS 2nd, Watson KC, Stanton FJ, et al. Recent experience in total shoulder replacement. J Bone Joint Surg Am. 1982;64(3):319–37. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed2&NEWS=N&AN=12153526.
Cofield RH. Total shoulder arthroplasty with the Neer prosthesis. J Bone Joint Surg Am. 1984;66(6):899–906.
Grammont P, Trouilloud P, Laffay JPDX. Concept study and realization of a new total shoulder prosthesis [French]. Rhumatologie. 1987;39:407–18.
Smithers CJ, Young AA, Walch G. Reverse shoulder arthroplasty. Curr Rev Musculoskelet Med. 2011;4(4):183–90.
Jazayeri R, Kwon YW. Evolution of the reverse total shoulder prosthesis. Bull NYU Hosp Joint Dis. 2011;69(1):50–5.
Nyffeler RW, Werner CML, Simmen BR, Gerber C. Analysis of a retrieved Delta III total shoulder prosthesis. J Bone Joint Surg. 2004;86(8):1187–91. http://www.bjj.boneandjoint.org.uk/cgi/doi/10.1302/0301-620X.86B8.15228.
Grammont PM, Baulot E. The classic: Delta shoulder prosthesis for rotator cuff rupture. 1993. Clin Orthop Relat Res. 2011;469(9):2424.
Gerber C, Pennington S, Nyffeler RW. Reverse total shoulder arthroplasty. J Am Acad Orthop Surg. 2009;17(5):284–95.
Nyffeler RW, Werner CML, Gerber C. Biomechanical relevance of glenoid component positioning in the reverse Delta III total shoulder prosthesis. J Shoulder Elbow Surg. 2005;14(5):524–8.
Gutiérrez S. The biomechanics of reverse shoulder arthroplasty. 2009. http://scholarcommons.usf.edu/etd, http://scholarcommons.usf.edu/etd/4800.
Farshad M, Gerber C. Reverse total shoulder arthroplasty—from the most to the least common complication. Int Orthop. 2010;34(8):1075–82.
Boileau P. Complications and revision of reverse total shoulder arthroplasty. Orthop Traumatol Surg Res. 2016;102(1):S33–43. https://doi.org/10.1016/j.otsr.2015.06.031.
Guery J, Fevard L, Sirveaux F, Oudet D, Mole D, Walch G. Reverse total shoulder arthroplasty. J Bone Joint Surg Am. 2006;88(8):1742–7. http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00004623-200608000-00008.
Gutiérrez S, Keller TS, Levy JC, Lee WE, Luo ZP. Hierarchy of stability factors in reverse shoulder arthroplasty. Clin Orthop Relat Res. 2008;466(3):670–6.
Henninger HB, Barg A, Anderson AE, Bachus KN, Tashjian RZ, Burks RT. Effect of deltoid tension and humeral version in reverse total shoulder arthroplasty: a biomechanical study. J Shoulder Elbow Surg. 2012;21(4):483–90. https://doi.org/10.1016/j.jse.2011.01.040.
Walker DR, Struk AM, Matsuki K, Wright TW, Banks SA. How do deltoid muscle moment arms change after reverse total shoulder arthroplasty? J Shoulder Elbow Surg. 2016;25(4):581–8. https://doi.org/10.1016/j.jse.2015.09.015.
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Bytyqi, D., Kafeloff, M., Shabani, B. (2020). Biomechanics of rTSA. In: Huri, G., Familiari, F., Moon, Y.L., Doral, M.N., Marcheggiani Muccioli, G.M. (eds) Shoulder Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-030-19285-3_4
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