Inferior tilt fixation of the glenoid component in reverse total shoulder arthroplasty: A biomechanical study

Soo Won Chae, Juneyoung Lee, S. H. Han, S. Y. Kim

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Glenoid component fixation with an inferior tilt has been suggested to decrease scapular notching, but this remains controversial. We aimed here to evaluate the effect of glenoid component inferior tilt in reverse total shoulder arthroplasty (RSA) on micromotion and loss of fixation of the glenoid component by biomechanical testing. Hypothesis: Increased inferior reaming of the glenoid for inferiorly tilted implantation of the glenoid component will decrease glenoid bone stock and compromise the fixation of RSA. Materials and methods: The micromotions of the glenoid components attached to 14 scapulae from fresh frozen cadavers were measured and compared between neutral and 10° inferior tilts in 0.7- and 1-body weight cyclic loading tests using digital-image analysis. The incidence of bone breakage or loss of fixation was assessed in the 1-body weight fatigue-loading test. Results: Micromotion was higher with a 10° inferior tilt than with a neutral tilt during both the 0.7-body weight (36 ± 11. μm vs. 22 ± 5. μm; P = 0.028) and 1-body weight (44 ± 16. μm vs. 28 ± 9. μm; P = 0.045) cyclic loading. The incidence of bone breakage or loss of fixation was 17% and 60% with a neutral and 10° inferior tilt, respectively. Discussion: Glenoid component inferior tilt fixation in RSA may reduce primary stability and increase mechanical failure of the glenoid component, thereby reducing longevity of the prosthesis. Accordingly, we recommend careful placement of the glenoid component when an inferior tilt is used. Level of evidence: Level III, Basic Science Study.

Original languageEnglish
Pages (from-to)421-425
Number of pages5
JournalOrthopaedics and Traumatology: Surgery and Research
Volume101
Issue number4
DOIs
Publication statusPublished - 2015 Jun 1

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Arthroplasty
Body Weight
Bone and Bones
Scapula
Incidence
Cadaver
Prostheses and Implants
Fatigue

Keywords

  • Glenoid component
  • Inferior tilt
  • Micromotion
  • Primary stability
  • Reverse total shoulder arthroplast

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

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title = "Inferior tilt fixation of the glenoid component in reverse total shoulder arthroplasty: A biomechanical study",
abstract = "Background: Glenoid component fixation with an inferior tilt has been suggested to decrease scapular notching, but this remains controversial. We aimed here to evaluate the effect of glenoid component inferior tilt in reverse total shoulder arthroplasty (RSA) on micromotion and loss of fixation of the glenoid component by biomechanical testing. Hypothesis: Increased inferior reaming of the glenoid for inferiorly tilted implantation of the glenoid component will decrease glenoid bone stock and compromise the fixation of RSA. Materials and methods: The micromotions of the glenoid components attached to 14 scapulae from fresh frozen cadavers were measured and compared between neutral and 10° inferior tilts in 0.7- and 1-body weight cyclic loading tests using digital-image analysis. The incidence of bone breakage or loss of fixation was assessed in the 1-body weight fatigue-loading test. Results: Micromotion was higher with a 10° inferior tilt than with a neutral tilt during both the 0.7-body weight (36 ± 11. μm vs. 22 ± 5. μm; P = 0.028) and 1-body weight (44 ± 16. μm vs. 28 ± 9. μm; P = 0.045) cyclic loading. The incidence of bone breakage or loss of fixation was 17{\%} and 60{\%} with a neutral and 10° inferior tilt, respectively. Discussion: Glenoid component inferior tilt fixation in RSA may reduce primary stability and increase mechanical failure of the glenoid component, thereby reducing longevity of the prosthesis. Accordingly, we recommend careful placement of the glenoid component when an inferior tilt is used. Level of evidence: Level III, Basic Science Study.",
keywords = "Glenoid component, Inferior tilt, Micromotion, Primary stability, Reverse total shoulder arthroplast",
author = "Chae, {Soo Won} and Juneyoung Lee and Han, {S. H.} and Kim, {S. Y.}",
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T1 - Inferior tilt fixation of the glenoid component in reverse total shoulder arthroplasty

T2 - A biomechanical study

AU - Chae, Soo Won

AU - Lee, Juneyoung

AU - Han, S. H.

AU - Kim, S. Y.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Background: Glenoid component fixation with an inferior tilt has been suggested to decrease scapular notching, but this remains controversial. We aimed here to evaluate the effect of glenoid component inferior tilt in reverse total shoulder arthroplasty (RSA) on micromotion and loss of fixation of the glenoid component by biomechanical testing. Hypothesis: Increased inferior reaming of the glenoid for inferiorly tilted implantation of the glenoid component will decrease glenoid bone stock and compromise the fixation of RSA. Materials and methods: The micromotions of the glenoid components attached to 14 scapulae from fresh frozen cadavers were measured and compared between neutral and 10° inferior tilts in 0.7- and 1-body weight cyclic loading tests using digital-image analysis. The incidence of bone breakage or loss of fixation was assessed in the 1-body weight fatigue-loading test. Results: Micromotion was higher with a 10° inferior tilt than with a neutral tilt during both the 0.7-body weight (36 ± 11. μm vs. 22 ± 5. μm; P = 0.028) and 1-body weight (44 ± 16. μm vs. 28 ± 9. μm; P = 0.045) cyclic loading. The incidence of bone breakage or loss of fixation was 17% and 60% with a neutral and 10° inferior tilt, respectively. Discussion: Glenoid component inferior tilt fixation in RSA may reduce primary stability and increase mechanical failure of the glenoid component, thereby reducing longevity of the prosthesis. Accordingly, we recommend careful placement of the glenoid component when an inferior tilt is used. Level of evidence: Level III, Basic Science Study.

AB - Background: Glenoid component fixation with an inferior tilt has been suggested to decrease scapular notching, but this remains controversial. We aimed here to evaluate the effect of glenoid component inferior tilt in reverse total shoulder arthroplasty (RSA) on micromotion and loss of fixation of the glenoid component by biomechanical testing. Hypothesis: Increased inferior reaming of the glenoid for inferiorly tilted implantation of the glenoid component will decrease glenoid bone stock and compromise the fixation of RSA. Materials and methods: The micromotions of the glenoid components attached to 14 scapulae from fresh frozen cadavers were measured and compared between neutral and 10° inferior tilts in 0.7- and 1-body weight cyclic loading tests using digital-image analysis. The incidence of bone breakage or loss of fixation was assessed in the 1-body weight fatigue-loading test. Results: Micromotion was higher with a 10° inferior tilt than with a neutral tilt during both the 0.7-body weight (36 ± 11. μm vs. 22 ± 5. μm; P = 0.028) and 1-body weight (44 ± 16. μm vs. 28 ± 9. μm; P = 0.045) cyclic loading. The incidence of bone breakage or loss of fixation was 17% and 60% with a neutral and 10° inferior tilt, respectively. Discussion: Glenoid component inferior tilt fixation in RSA may reduce primary stability and increase mechanical failure of the glenoid component, thereby reducing longevity of the prosthesis. Accordingly, we recommend careful placement of the glenoid component when an inferior tilt is used. Level of evidence: Level III, Basic Science Study.

KW - Glenoid component

KW - Inferior tilt

KW - Micromotion

KW - Primary stability

KW - Reverse total shoulder arthroplast

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