Cargando…

Biomechanical Value of a Protective Proximal Humeral Cerclage in Reverse Total Shoulder Arthroplasty

Reverse shoulder arthroplasty (RSA) is a commonly performed salvage procedure for failed proximal humeral fracture fixation. The rate of intraoperative periprosthetic fractures is higher compared to primary RSA. The goal of this study was to investigate the biomechanical value of a protective cercla...

Descripción completa

Detalles Bibliográficos
Autores principales: Michel, Philipp A., Katthagen, J. Christoph, Schliemann, Benedikt, Wilkens, Sina, Frank, Andre, Heilmann, Lukas F., Dyrna, Felix, Raschke, Michael J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509515/
https://www.ncbi.nlm.nih.gov/pubmed/34640617
http://dx.doi.org/10.3390/jcm10194600
_version_ 1784582360420843520
author Michel, Philipp A.
Katthagen, J. Christoph
Schliemann, Benedikt
Wilkens, Sina
Frank, Andre
Heilmann, Lukas F.
Dyrna, Felix
Raschke, Michael J.
author_facet Michel, Philipp A.
Katthagen, J. Christoph
Schliemann, Benedikt
Wilkens, Sina
Frank, Andre
Heilmann, Lukas F.
Dyrna, Felix
Raschke, Michael J.
author_sort Michel, Philipp A.
collection PubMed
description Reverse shoulder arthroplasty (RSA) is a commonly performed salvage procedure for failed proximal humeral fracture fixation. The rate of intraoperative periprosthetic fractures is higher compared to primary RSA. The goal of this study was to investigate the biomechanical value of a protective cerclage during stem impaction in a revision surgery setting. Twenty-eight fresh-frozen human humeri were used to assess different configurations for steel wire and FiberTape cerclages. A custom-built biomechanical test setup simulated the mallet strikes during the stem impaction process with the Univers Revers prothesis stem. The mallet energy until the occurrence of a first crack was not different between groups. The total energy until progression of the fracture distally to the cerclage was significantly higher in the cerclage groups compared to the native humerus (9.5 J vs. 3.5 J, respectively; p = 0.0125). There was no difference between the steel wire and FiberTape groups (11.4 J vs. 8.6 J, respectively; p = 0.2695). All fractures were located at the concave side of the stem at the metaphyseal calcar region. This study demonstrates that a protective cerclage can successfully delay the occurrence of a fracture during stem impaction in reverse shoulder arthroplasty. A FiberTape cerclage is biomechanically equally efficient compared to a steel wire cerclage.
format Online
Article
Text
id pubmed-8509515
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-85095152021-10-13 Biomechanical Value of a Protective Proximal Humeral Cerclage in Reverse Total Shoulder Arthroplasty Michel, Philipp A. Katthagen, J. Christoph Schliemann, Benedikt Wilkens, Sina Frank, Andre Heilmann, Lukas F. Dyrna, Felix Raschke, Michael J. J Clin Med Article Reverse shoulder arthroplasty (RSA) is a commonly performed salvage procedure for failed proximal humeral fracture fixation. The rate of intraoperative periprosthetic fractures is higher compared to primary RSA. The goal of this study was to investigate the biomechanical value of a protective cerclage during stem impaction in a revision surgery setting. Twenty-eight fresh-frozen human humeri were used to assess different configurations for steel wire and FiberTape cerclages. A custom-built biomechanical test setup simulated the mallet strikes during the stem impaction process with the Univers Revers prothesis stem. The mallet energy until the occurrence of a first crack was not different between groups. The total energy until progression of the fracture distally to the cerclage was significantly higher in the cerclage groups compared to the native humerus (9.5 J vs. 3.5 J, respectively; p = 0.0125). There was no difference between the steel wire and FiberTape groups (11.4 J vs. 8.6 J, respectively; p = 0.2695). All fractures were located at the concave side of the stem at the metaphyseal calcar region. This study demonstrates that a protective cerclage can successfully delay the occurrence of a fracture during stem impaction in reverse shoulder arthroplasty. A FiberTape cerclage is biomechanically equally efficient compared to a steel wire cerclage. MDPI 2021-10-06 /pmc/articles/PMC8509515/ /pubmed/34640617 http://dx.doi.org/10.3390/jcm10194600 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Michel, Philipp A.
Katthagen, J. Christoph
Schliemann, Benedikt
Wilkens, Sina
Frank, Andre
Heilmann, Lukas F.
Dyrna, Felix
Raschke, Michael J.
Biomechanical Value of a Protective Proximal Humeral Cerclage in Reverse Total Shoulder Arthroplasty
title Biomechanical Value of a Protective Proximal Humeral Cerclage in Reverse Total Shoulder Arthroplasty
title_full Biomechanical Value of a Protective Proximal Humeral Cerclage in Reverse Total Shoulder Arthroplasty
title_fullStr Biomechanical Value of a Protective Proximal Humeral Cerclage in Reverse Total Shoulder Arthroplasty
title_full_unstemmed Biomechanical Value of a Protective Proximal Humeral Cerclage in Reverse Total Shoulder Arthroplasty
title_short Biomechanical Value of a Protective Proximal Humeral Cerclage in Reverse Total Shoulder Arthroplasty
title_sort biomechanical value of a protective proximal humeral cerclage in reverse total shoulder arthroplasty
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509515/
https://www.ncbi.nlm.nih.gov/pubmed/34640617
http://dx.doi.org/10.3390/jcm10194600
work_keys_str_mv AT michelphilippa biomechanicalvalueofaprotectiveproximalhumeralcerclageinreversetotalshoulderarthroplasty
AT katthagenjchristoph biomechanicalvalueofaprotectiveproximalhumeralcerclageinreversetotalshoulderarthroplasty
AT schliemannbenedikt biomechanicalvalueofaprotectiveproximalhumeralcerclageinreversetotalshoulderarthroplasty
AT wilkenssina biomechanicalvalueofaprotectiveproximalhumeralcerclageinreversetotalshoulderarthroplasty
AT frankandre biomechanicalvalueofaprotectiveproximalhumeralcerclageinreversetotalshoulderarthroplasty
AT heilmannlukasf biomechanicalvalueofaprotectiveproximalhumeralcerclageinreversetotalshoulderarthroplasty
AT dyrnafelix biomechanicalvalueofaprotectiveproximalhumeralcerclageinreversetotalshoulderarthroplasty
AT raschkemichaelj biomechanicalvalueofaprotectiveproximalhumeralcerclageinreversetotalshoulderarthroplasty