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Hierarchy of Stability Factors in Reverse Shoulder Arthroplasty

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Clinical Orthopaedics and Related Research

Abstract

Reverse shoulder arthroplasty is being used more frequently to treat irreparable rotator cuff tears in the presence of glenohumeral arthritis and instability. To date, however, design features and functions of reverse shoulder arthroplasty, which may be associated with subluxation and dislocation of these implants, have been poorly understood. We asked: (1) what is the hierarchy of importance of joint compressive force, prosthetic socket depth, and glenosphere size in relation to stability, and (2) is this hierarchy defined by underlying and theoretically predictable joint contact characteristics? We examined the intrinsic stability in terms of the force required to dislocate the humerosocket from the glenosphere of eight commercially available reverse shoulder arthroplasty devices. The hierarchy of factors was led by compressive force followed by socket depth; glenosphere size played a much lesser role in stability of the reverse shoulder arthroplasty device. Similar results were predicted by a mathematical model, suggesting the stability was determined primarily by compressive forces generated by muscles.

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References

  1. American Society for Testing and Materials (ASTM). Standard specification for ultra-high-molecular-weight polyethylene powder and fabricated form for surgical implants. Designation F648–696.

  2. Anglin C, Wyss UP, Pichora DR. Shoulder prosthesis subluxation: theory and experiment. J Shoulder Elbow Surg. 2000;9:104–114.

    Article  PubMed  CAS  Google Scholar 

  3. Boileau P, Watkinson DJ, Hatzidakis AM, Balg F. Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg. 2005;14(1 suppl S):147S–161S.

    Article  PubMed  Google Scholar 

  4. Bonnet DG, Seier E. Confidence intervals for mean absolute deviations. Am Stat. Nov. 2003;57:233–236.

    Google Scholar 

  5. Boulahia A, Edwards TB, Walch G, Baratta RV. Early results of a reverse design prosthesis in the treatment of arthritis of the shoulder in elderly patients with a large rotator cuff tear. Orthopedics. 2002;25:129–133.

    PubMed  Google Scholar 

  6. Brockett C, Williams S, Jin Z, Isaac G, Fisher J. Friction of total hip replacements with different bearings and loading conditions. J Biomed Mater Res B Appl Biomater. 2007;81:508–515.

    PubMed  Google Scholar 

  7. Bufquin T, Hersan A, Hubert L, Massin P. Reverse shoulder arthroplasty for the treatment of three- and four-part fractures of the proximal humerus in the elderly: a prospective review of 43 cases with a short-term follow-up. J Bone Joint Surg Br. 2007;89:516–520.

    Article  PubMed  CAS  Google Scholar 

  8. Cazeneuve JF, Cristofari DJ. [Grammont reversed prosthesis for acute complex fracture of the proximal humerus in an elderly population with 5 to 12 years follow-up] [in French]. Rev Chir Orthop Reparatrice Appar Mot. 2006;92:543–548.

    PubMed  Google Scholar 

  9. De Wilde L, Mombert M, Van Petegem P, Verdonk R. Revision of shoulder replacement with a reversed shoulder prosthesis (Delta III): report of five cases. Acta Orthop Belg. 2001;67:348–353.

    PubMed  Google Scholar 

  10. De Wilde L, Sys G, Julien Y, Van Ovost E, Poffyn B, Trouilloud P. The reversed Delta shoulder prosthesis in reconstruction of the proximal humerus after tumour resection. Acta Orthop Belg. 2003;69:495–500.

    PubMed  Google Scholar 

  11. Endo K, Ikata T, Katoh S, Takeda Y. Radiographic assessment of scapular rotational tilt in chronic shoulder impingement syndrome. J Orthop Sci. 2001;6:3–10.

    Article  PubMed  CAS  Google Scholar 

  12. Favard L, Lautmann S, Sirveaux F, Oudet D, Kerjean Y, Huguet D. Hemi-arthroplasty versus reverse arthroplasty in treatment of osteoarthritis with massive rotator cuff tear. In: Walch G, Boileau P, Molé D, eds. 2000 Prothéses d’épaule: recul de 2 à 10 ans. Paris, France: Sauramps Médical; 2001:261–268.

    Google Scholar 

  13. Frankle M, Siegal S, Pupello D, Saleem A, Mighell M, Vasey M. The Reverse Shoulder Prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency: a minimum two-year follow-up study of sixty patients. J Bone Joint Surg Am. 2005;87:1697–1705.

    Article  PubMed  Google Scholar 

  14. Friction Center Coefficient Database. Center for Advanced Friction Studies, Southern Illinois University Carbondale, 2005. Available at: http://frictioncenter.siu.edu/databaseSearch.html. Accessed 22 October 2007.

  15. Gutiérrez S, Levy JC, Lee WE 3rd, Keller TS, Maitland ME. Center of rotation affects abduction range of motion of reverse shoulder arthroplasty. Clin Orthop Relat Res. 2007;458:78–82.

    PubMed  Google Scholar 

  16. Halder AM, Kuhl SG, Zobitz ME, Larson D, An KN. Effects of the glenoid labrum and glenohumeral abduction on stability of the shoulder joint through concavity-compression: an in vitro study. J Bone Joint Surg Am. 2001;83:1062–1069.

    PubMed  Google Scholar 

  17. Halder AM, Zhao KD, Odriscoll SW, Morrey BF, An KN. Dynamic contributions to superior shoulder stability. J Orthop Res. 2001;19:206–212.

    Article  PubMed  CAS  Google Scholar 

  18. Karduna AR, Williams GR, Williams JL, Iannotti JP. Joint stability after total shoulder arthroplasty in a cadaver model. J Shoulder Elbow Surg. 1997;6:506–511.

    Article  PubMed  CAS  Google Scholar 

  19. Kirk RE. Experimental Design: Procedures for the Behavioral Sciences. 3rd ed. Pacific Grove, CA: Brooks/Cole; 1995.

    Google Scholar 

  20. Labriola JE, Lee TQ, Debski RE, McMahon PJ. Stability and instability of the glenohumeral joint: the role of shoulder muscles. J Shoulder Elbow Surg. 2005;14(1 suppl S):32S–38S.

    Article  PubMed  Google Scholar 

  21. 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;82:849–857.

    PubMed  CAS  Google Scholar 

  22. Lin JJ, Lim HK, Yang JL. Effect of shoulder tightness on glenohumeral translation, scapular kinematics, and scapulohumeral rhythm in subjects with stiff shoulders. J Orthop Res. 2006;24:1044–1051.

    Article  PubMed  Google Scholar 

  23. Linn FC. Lubrication of animal joints. I. The arthrotripsometer. J Bone Joint Surg Am. 1967;49:1079–1098.

    PubMed  CAS  Google Scholar 

  24. Matsen FA 3rd, Chebli C, Lippitt S; American Academy of Orthopaedic Surgeons. Principles for the evaluation and management of shoulder instability. J Bone Joint Surg Am. 2006;88:648–659.

    PubMed  Google Scholar 

  25. Nyffeler RW, Werner CM, Gerber C. Biomechanical relevance of glenoid component positioning in the reverse Delta III total shoulder prosthesis. J Shoulder Elbow Surg. 2005;14:524–528.

    Article  PubMed  Google Scholar 

  26. Oosterom R, Herder JL, van der Helm FC, Swieszkowski W, Bersee HE. Translational stiffness of the replaced shoulder joint. J Biomech. 2003;36:1897–1907.

    Article  PubMed  CAS  Google Scholar 

  27. Parsons IM, Apreleva M, Fu FH, Woo SL. The effect of rotator cuff tears on reaction forces at the glenohumeral joint. J Orthop Res. 2002;20:439–446.

    Article  PubMed  CAS  Google Scholar 

  28. Rittmeister M, Kerschbaumer F. Grammont reverse total shoulder arthroplasty in patients with rheumatoid arthritis and nonreconstructible rotator cuff lesions. J Shoulder Elbow Surg. 2001;10:17–22.

    Article  PubMed  CAS  Google Scholar 

  29. Roberts BJ, Unsworth A, Mian N. Modes of lubrication in human hip joints. Ann Rheum Dis. 1982;41:217–224.

    Article  PubMed  CAS  Google Scholar 

  30. Scholes SC, Unsworth A. Comparison of friction and lubrication of different hip prostheses. Proc Inst Mech Eng H. 2000;214:49–57.

    Article  PubMed  CAS  Google Scholar 

  31. Tammachote N, Sperling JW, Berglund LJ, Steinmann SP, Cofield RH, An KN. The effect of glenoid component size on the stability of total shoulder arthroplasty. J Shoulder Elbow Surg. 2007;16(3 suppl):S102–S106.

    Article  PubMed  Google Scholar 

  32. Valenti PH, Boutens D, Nerot C. Delta 3 reversed prosthesis for osteoarthritis with massive rotator cuff tear: long term results. In: Walch G, Boileau P, Molé D, eds. 2000 Prothéses d’épaule: recul de 2 à 10 ans. Paris, France: Sauramps Médical; 2001:253–259.

    Google Scholar 

  33. van der Helm FC. Analysis of the kinematic and dynamic behavior of the shoulder mechanism. J Biomech. 1994;27:527–550.

    Article  PubMed  Google Scholar 

  34. Van Seymortier P, Stoffelen D, Fortems Y, Reynders P. The reverse shoulder prosthesis (Delta III) in acute shoulder fractures: technical considerations with respect to stability. Acta Orthop Belg. 2006;72:474–477.

    PubMed  Google Scholar 

  35. Wall B, Nové -Josserand L, O’Connor DP, Edwards TB, Walch G. Reverse total shoulder arthroplasty: a review of results according to etiology. J Bone Joint Surg Am. 2007;89:1476–1485.

    Article  PubMed  Google Scholar 

  36. Werner CM, Steinmann PA, Gilbart M, Gerber C. Treatment of painful pseudoparesis due to irreparable rotator cuff dysfunction with the Delta III reverse-ball-and-socket total shoulder prosthesis. J Bone Joint Surg Am. 2005;87:1476–1486.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

We thank Allen Smith and Karmen Anderson for technical support.

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Authors and Affiliations

  1. University of South Florida, College of Engineering, Chemical and Biomedical Engineering, Tampa, FL, USA

    Sergio Gutiérrez MS & William E. Lee III PhD

  2. Florida Orthopaedic Institute, 13020 N Telecom Parkway, Tampa, FL, 33637, USA

    Sergio Gutiérrez MS, Tony S. Keller PhD & Zong-Ping Luo PhD

  3. The Orthopaedic Institute at Holy Cross Hospital, Fort Lauderdale, FL, USA

    Jonathan C. Levy MD

Authors
  1. Sergio Gutiérrez MS
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  2. Tony S. Keller PhD
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  3. Jonathan C. Levy MD
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  4. William E. Lee III PhD
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  5. Zong-Ping Luo PhD
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Corresponding author

Correspondence to Zong-Ping Luo PhD.

Additional information

Deceased.

SG, TSK, and ZPL received funding from the Florida Orthopaedic Institute Research Foundation.

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Gutiérrez, S., Keller, T.S., Levy, J.C. et al. Hierarchy of Stability Factors in Reverse Shoulder Arthroplasty. Clin Orthop Relat Res 466, 670–676 (2008). https://doi.org/10.1007/s11999-007-0096-0

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  • DOI: https://doi.org/10.1007/s11999-007-0096-0

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