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Mal-aligning humeral offset may not effect shoulder hemiarthroplasty: a biomechanical study.

Abstract：

BACKGROUND:Component mal-positioning may contribute to a poor clinical outcome after hemiarthroplasty. Eccentric head components, recently introduced, allow posterior offset of the humeral head relative to the shaft so the purpose of this study was to determine effects of mal-aligning humeral head offset. MATERIAL/METHODS:Five glenohumeral joints were each placed in 60 and 90 degrees of shoulder abduction and in apprehension positions using a custom shoulder-testing device. Joint reaction force and contact areas, pressures and patterns were measured. Humeral head offset was then mal-aligned by rotating the eccentric head component 90 degrees and testing was repeated. RESULTS:There were no significant differences in the joint reaction forces in comparison of the hemiarthoplasies that mimicked and mal-aligned humeral offset. A significant increase in total contact area was found only at 60 degrees of abduction, increasing from 137.4+/-32.2 millimeters(2) to 243.4+/-27.0 millimeters(2). (p<0.05) No changes were found in contact pressures; only the patterns of contact were meaningfully different after hemiarthroplasty mal-aligned in humeral offset. In the apprehension position, rather than elongated ovals, there were multiple irregular patterns in the posterior joint. CONCLUSIONS:Meaningful alterations in joint biomechanics did not result from hemiarthroplasty that mal-aligned humeral offset, albeit the mal-alignments studied were small. Glenoid impingement with the humeral metaphysis may occur if portions of the humeral osteotomy surface, not covered by the head component, are not chamfered during the surgical procedure.

journal_name

Med Sci Monit

journal_title

Medical science monitor : international medical journal of experimental and clinical research

authors

McMahon PJ,Dee DT,Yang BY,Lee TQ

subject

Has Abstract

pub_date

2003-08-01 00:00:00

pages

CR346-52

issue

8

eissn

1234-1010

issn

1643-3750

pii

3356

journal_volume

9

pub_type

杂志文章

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