Abstract:
BACKGROUND:Reverse total shoulder arthroplasty (RTSA) is widely used; however, the effects of RTSA geometric parameters on joint and muscle loading, which strongly influence implant survivorship and long-term function, are not well understood. By investigating these parameters, it should be possible to objectively optimize RTSA design and implantation technique. QUESTIONS/PURPOSES:The purposes of this study were to evaluate the effect of RTSA implant design parameters on (1) the deltoid muscle forces required to produce abduction, and (2) the magnitude of joint load and (3) the loading angle throughout this motion. We also sought to determine how these parameters interacted. METHODS:Seven cadaveric shoulders were tested using a muscle load-driven in vitro simulator to achieve repeatable motions. The effects of three implant parameters-humeral lateralization (0, 5, 10 mm), polyethylene thickness (3, 6, 9 mm), and glenosphere lateralization (0, 5, 10 mm)-were assessed for the three outcomes: deltoid muscle force required to produce abduction, magnitude of joint load, and joint loading angle throughout abduction. RESULTS:Increasing humeral lateralization decreased deltoid forces required for active abduction (0 mm: 68% ± 8% [95% CI, 60%-76% body weight (BW)]; 10 mm: 65% ± 8% [95% CI, 58%-72 % BW]; p = 0.022). Increasing glenosphere lateralization increased deltoid force (0 mm: 61% ± 8% [95% CI, 55%-68% BW]; 10 mm: 70% ± 11% [95% CI, 60%-81% BW]; p = 0.007) and joint loads (0 mm: 53% ± 8% [95% CI, 46%-61% BW]; 10 mm: 70% ± 10% [95% CI, 61%-79% BW]; p < 0.001). Increasing polyethylene cup thickness increased deltoid force (3 mm: 65% ± 8% [95% CI, 56%-73% BW]; 9 mm: 68% ± 8% [95% CI, 61%-75% BW]; p = 0.03) and joint load (3 mm: 60% ± 8% [95% CI, 53%-67% BW]; 9 mm: 64% ± 10% [95% CI, 56%-72% BW]; p = 0.034). CONCLUSIONS:Humeral lateralization was the only parameter that improved joint and muscle loading, whereas glenosphere lateralization resulted in increased loads. Humeral lateralization may be a useful implant parameter in countering some of the negative effects of glenosphere lateralization, but this should not be considered the sole solution for the negative effects of glenosphere lateralization. Overstuffing the articulation with progressively thicker humeral polyethylene inserts produced some adverse effects on deltoid muscle and joint loading. CLINICAL RELEVANCE:This systematic evaluation has determined that glenosphere lateralization produces marked negative effects on loading outcomes; however, the importance of avoiding scapular notching may outweigh these effects. Humeral lateralization's ability to decrease the effects of glenosphere lateralization was promising but further investigations are required to determine the effects of combined lateralization on functional outcomes including range of motion.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Giles JW,Langohr GD,Johnson JA,Athwal GSdoi
10.1007/s11999-015-4526-0subject
Has Abstractpub_date
2015-11-01 00:00:00pages
3615-26issue
11eissn
0009-921Xissn
1528-1132pii
10.1007/s11999-015-4526-0journal_volume
473pub_type
杂志文章abstract::There are 2 fairly common types of spondylolisthesis in children - dysplastic and isthmic. The dysplastic type is secondary to congenital defects at the lumbosacral joint. The isthmic is usually due to a fatigue fracture of the pars interarticularis but there is also an hereditary element in this type. Most children w...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1976-06-01 00:00:00
abstract::Milwaukee brace treatment for patients with idiopathic scoliosis very rarely accomplishes improvement approaching that of successful surgery. Prpgression of small and medium-sized curves (60 degrees or less) has been routinely halted. Few curves progress with adequate brace treatment. Occasionally, improvement in defo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-07-01 00:00:00
abstract::Two hundred thirty-four primary total knee prostheses were evaluated with a 45 degrees merchant view to examine patellar position and fixation. Despite a standardized technique for obtaining roentgenographs, patellar position varied with leg position. Overall, 54.7% tracked centrally, 31.2% tilted, and 14.5% displaced...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::Although hemiarthroplasties are an important treatment for femoral neck fractures, the literature does not provide a clear approach for selecting the implant fixation method. Therefore, we performed a systematic search of the medical literature and identified 11 prospective and retrospective studies that compared resu...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s11999-008-0368-3
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Normal function of the upper limb is seldom restored after limb-sparing surgery for tumors of the proximal humerus. The literature suggests superior shoulder function is achieved in the short term with reverse total shoulder arthroplasty compared to other techniques when performed for conditions with rotator...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1758-x
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Patellofemoral osteoarthritis (OA) and anterior knee pain sometimes are considered contraindications for unicompartmental knee arthroplasty (UKA). However, several studies have demonstrated excellent patient-reported outcome scores in patients with patellofemoral OA treated with medial mobile-bearing UKA. Be...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000000738
更新日期:2019-09-01 00:00:00
abstract::This study evaluates the three-dimensional anatomy of the femur with congenital dysplasia of the hip (CDH) in comparison with healthy controls. Computed tomographic scans were obtained from 207 women (154 with dysplasia; 54 healthy controls) with an average age of 51.6 years (range, 18-82 years). Most of the dysplasti...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:30.3097/01.blo.0000096819.67494.32
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:Fracture-dislocations of the proximal interphalangeal joint are vexing because subluxation and articular damage can lead to arthrosis and the treatments are imperfect. Ideally, a surgeon could advise a patient, based on radiographs, when the risk of problems merits operative intervention, but it is unclear i...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-015-4394-7
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Treatment of giant cell tumor of bone (GCT) often is complicated by local recurrence. Intralesional curettage is the standard of care for primary GCTs. However, there is controversy whether intralesional curettage should be preferred over wide resection in recurrent GCTs. QUESTIONS/PURPOSES:We investigated ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1560-9
更新日期:2011-04-01 00:00:00
abstract::Arthrodesis of the carpometacarpal joint of the thumb is useful in reconstruction of hand deficiencies and in eliminating pain at this site. The author has speculated that fusion of the carpometacarpal joint might lead to pantrapezial arthritis in later years. No patients with painful arthritis received this operation...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-07-01 00:00:00
abstract:UNLABELLED:Acetabular component orientation during total hip arthroplasty affects dislocation, range of motion, polyethylene wear, pelvic osteolysis, and component migration. New total hip arthroplasty navigation systems have been introduced to avoid the errors reported after acetabular component orientation using a ma...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000201165.82690.f8
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:The notion that neutral alignment is mandatory to assure long-term durability after TKA has been based mostly on short-film studies. However, this is challenged by recent long-film studies. QUESTIONS/PURPOSES:We conducted this long-film study to know (1) whether the risk of aseptic revision for nontraumatic...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999.0000000000000012
更新日期:2018-02-01 00:00:00
abstract::The treatment of hip disorders in adolescents and young adults has evolved rapidly during the past decade because of enhanced understanding of prearthritic and early arthritic hip disease combined with improved diagnostic skills, better patient selection criteria, and refinements in alternative surgical procedures. De...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000193511.91643.2a
更新日期:2005-12-01 00:00:00
abstract::Chondrocytes from adult and immature articular cartilage were separated on the basis of size by rate-zonal centrifugation in a Ficoll density gradient. Lysozomal enzyme activity (acid phosphatase and beta-glucuronidase) was determined in gradient fractions containing chondrocytes of different sizes. Acid phosphatase a...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-04-01 00:00:00
abstract::Infected arthroplasties reportedly have a lower eradication rate when caused by highly resistant and/or polymicrobial isolates and in these patients most authors recommend intravenous antibiotics. We asked whether two-stage revision with interim oral antibiotics could eradicate these infections. We prospectively follo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-0808-8
更新日期:2009-09-01 00:00:00
abstract::Postoperative duplex ultrasonography screening after total hip arthroplasty has been shown to identify patients who may require treatment or additional monitoring for venous thromboembolic disease. The potential for manifestation of venous thromboembolic disease subsequent to screening remains a concern. The objective...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199904000-00022
更新日期:1999-04-01 00:00:00
abstract::Whether a preoperative long leg radiograph taken with the patient standing helps the surgeon reproduce a normal mechanical axis after total knee arthroplasty is unknown. The purpose of the current study was to evaluate whether a preoperative long leg radiograph helps to restore normal limb alignment after total knee a...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003086-200211000-00032
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:Most patients expect an improvement of walking ability and an increase in activity levels after TKA. Unfortunately, few studies report qualitative and quantitative activity improvements after TKA. QUESTIONS/PURPOSES:The aims of this study were (1) to evaluate quantity and quality of physical activity before...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-014-3813-5
更新日期:2014-12-01 00:00:00
abstract::A retrospective review was performed on 20 patients treated at the authors' hospital between 1961 and 1981 with noninfected nonunions following primary open reduction and internal fixation (ORIF) of intertrochanteric femoral fractures. All patients were available for follow-up examination. Each patient was interviewed...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-05-01 00:00:00
abstract::The success of a total hip arthroplasty (THA) is dependent on many more parameters than simply the prosthesis used. This study has demonstrated that a randomized controlled clinical trial of 250 patients comparing two types of hip prostheses (cemented versus cementless) with virtually complete follow-up examination is...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Wound necrosis is a potentially devastating complication of complex knee reconstruction. Laser-assisted indocyanine green angiography (LA-ICGA) is a technology that has been described in the plastic surgery literature to provide an objective assessment of skin perfusion in the operating room. This novel tech...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-014-3612-z
更新日期:2015-01-01 00:00:00
abstract::Various guidelines have been proposed regarding which portions of a surgical gown may be considered sterile. Unfortunately, the validity of these recommendations has not been definitively established. We therefore evaluated gown sterility after major spinal surgery to assess the legitimacy of these guidelines. We used...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0341-1
更新日期:2009-03-01 00:00:00
abstract::A quantitative three-dimensional measurement method, radiographic stereophotogrammetry (SPG), was employed to assess the relation between early subsidence of the femoral prosthesis after total hip arthroplasty (THA) and subsequent clinical course. The SPG technique and the authors' error control mechanisms are describ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1985-12-01 00:00:00
abstract::To update the status of chymopapain in the treatment of herniated intervertebral discs, a review of the current literature and data from an unpublished Texas study are presented. Studies in animals and humans have consistently demonstrated that chymopapain can dissolve the nucleus pulposus. Twenty-eight uncontrolled a...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章,评审
doi:
更新日期:1984-03-01 00:00:00
abstract::The rationale for and experience with the use of a hemispherical, cementless, microporous socket (Harris-Galante prosthesis) are presented as an approach to acetabular revision arthroplasty. Advantages are noted in preservation of existing bone, ease of rigid fixation, and bone grafting with either lyophylized particl...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-10-01 00:00:00
abstract:BACKGROUND:Subchondral insufficiency fracture of the femoral head occurs mainly in elderly patients with osteoporosis. Spontaneous resolution is observed after nonoperative treatment in some patients whereas other show progressive joint destruction requiring THA. Several studies report the occurrence of subchondral ins...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-1213-z
更新日期:2010-05-01 00:00:00
abstract::One hundred twenty-one knees with medial compartment osteoarthrosis were treated by unicompartmental arthroplasty with the Oxford Knee. The strict selection criteria were (1) the presence of a functioning anterior cruciate ligament, (2) fully correctable deformity, and (3) full thickness of articular cartilage in the ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract:BACKGROUND:Patients with local recurrence of soft-tissue sarcomas have a poor overall survival. High-grade, soft-tissue sarcomas in deep locations may have a poorer prognosis regarding local recurrence than low-grade sarcomas or those located superficially. Although previous reports evaluated tumors at various depths, ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2017-5
更新日期:2012-03-01 00:00:00
abstract::Clinicians have been concerned that fractures do not heal properly in individuals exposed to bisphosphonate treatment, a treatment that strongly affects bone metabolism. The current study attempted to clarify the long-term effects of clodronate (dichloromethylene bisphosphonate) treatment on fracture healing in growin...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200303000-00036
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:Surgical navigation in TKA facilitates better alignment; however, it is unclear whether improved alignment alters clinical evolution and midterm and long-term complication rates. QUESTIONS/PURPOSES:We determined the alignment differences between patients with standard, manual, jig-based TKAs and patients wi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11999-011-2044-2
更新日期:2011-12-01 00:00:00