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Elliptical and spherical heads show similar obligate glenohumeral translation during axial rotation in total shoulder arthroplasty
BACKGROUND: Elliptical shape humeral head prostheses have been recently proposed to reflect a more anatomic shoulder replacement. However, its effect on obligate glenohumeral translation during axial rotation compared to a standard spherical head is still not well understood. The purpose of the stud...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9990317/ https://www.ncbi.nlm.nih.gov/pubmed/36882825 http://dx.doi.org/10.1186/s12891-023-06273-5 |
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author | Muench, Lukas N. Murphey, Matthew Oei, Bridget Kia, Cameron Obopilwe, Elifho Cote, Mark P. Mazzocca, Augustus D. Berthold, Daniel P. |
author_facet | Muench, Lukas N. Murphey, Matthew Oei, Bridget Kia, Cameron Obopilwe, Elifho Cote, Mark P. Mazzocca, Augustus D. Berthold, Daniel P. |
author_sort | Muench, Lukas N. |
collection | PubMed |
description | BACKGROUND: Elliptical shape humeral head prostheses have been recently proposed to reflect a more anatomic shoulder replacement. However, its effect on obligate glenohumeral translation during axial rotation compared to a standard spherical head is still not well understood. The purpose of the study was to compare obligate humeral translation during axial rotation using spherical and elliptical shaped humeral head prostheses. It was hypothesized that the spherical head design would show significantly more obligate translation when compared to the elliptical design. METHODS: Six fresh-frozen cadaveric shoulders were utilized for biomechanical testing of internal (IR) and external (ER) rotation at various levels of abduction (0°, 30°, 45°, 60°) with lines of pull along each of the rotator cuff muscles. Each specimen underwent the following three conditions: (1) native; total shoulder arthroplasty (TSA) using (2) an elliptical and (3) spherical humeral head implant. Obligate translation during IR and ER was quantified using a 3-dimensional digitizer. The radius of curvature of the superoinferior and anteroposterior dimensions of the implants was calculated across each condition. RESULTS: Posterior and inferior translation as well as compound motion of spherical and elliptical heads during ER was similar at all abduction angles (P > 0.05, respectively). Compared to the native humeral head, both implants demonstrated significantly decreased posterior translation at 45° (elliptical: P = 0.003; spherical: P = 0.004) and 60° of abduction (elliptical: P < 0.001; spherical: P < 0.001). During internal rotation at 0° abduction, the spherical head showed significantly more compound motion (P = 0.042) compared to the elliptical head. The spherical implant also demonstrated increased anterior translation and compound motion during internal rotation at 60° abduction (P < 0.001) compared to the resting state. This difference was not significant for the native or elliptical head design at this angle (P > 0.05). CONCLUSION: In the setting of TSA, elliptical and spherical head implants showed similar obligate translation and overall compound motion during axial rotation. A gained understanding of the consequences of implant head shape in TSA may guide future surgical implant choice for better recreation of native shoulder kinematics and potentially improved patient outcomes. LEVEL OF EVIDENCE: Controlled Laboratory Study. |
format | Online Article Text |
id | pubmed-9990317 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-99903172023-03-08 Elliptical and spherical heads show similar obligate glenohumeral translation during axial rotation in total shoulder arthroplasty Muench, Lukas N. Murphey, Matthew Oei, Bridget Kia, Cameron Obopilwe, Elifho Cote, Mark P. Mazzocca, Augustus D. Berthold, Daniel P. BMC Musculoskelet Disord Research BACKGROUND: Elliptical shape humeral head prostheses have been recently proposed to reflect a more anatomic shoulder replacement. However, its effect on obligate glenohumeral translation during axial rotation compared to a standard spherical head is still not well understood. The purpose of the study was to compare obligate humeral translation during axial rotation using spherical and elliptical shaped humeral head prostheses. It was hypothesized that the spherical head design would show significantly more obligate translation when compared to the elliptical design. METHODS: Six fresh-frozen cadaveric shoulders were utilized for biomechanical testing of internal (IR) and external (ER) rotation at various levels of abduction (0°, 30°, 45°, 60°) with lines of pull along each of the rotator cuff muscles. Each specimen underwent the following three conditions: (1) native; total shoulder arthroplasty (TSA) using (2) an elliptical and (3) spherical humeral head implant. Obligate translation during IR and ER was quantified using a 3-dimensional digitizer. The radius of curvature of the superoinferior and anteroposterior dimensions of the implants was calculated across each condition. RESULTS: Posterior and inferior translation as well as compound motion of spherical and elliptical heads during ER was similar at all abduction angles (P > 0.05, respectively). Compared to the native humeral head, both implants demonstrated significantly decreased posterior translation at 45° (elliptical: P = 0.003; spherical: P = 0.004) and 60° of abduction (elliptical: P < 0.001; spherical: P < 0.001). During internal rotation at 0° abduction, the spherical head showed significantly more compound motion (P = 0.042) compared to the elliptical head. The spherical implant also demonstrated increased anterior translation and compound motion during internal rotation at 60° abduction (P < 0.001) compared to the resting state. This difference was not significant for the native or elliptical head design at this angle (P > 0.05). CONCLUSION: In the setting of TSA, elliptical and spherical head implants showed similar obligate translation and overall compound motion during axial rotation. A gained understanding of the consequences of implant head shape in TSA may guide future surgical implant choice for better recreation of native shoulder kinematics and potentially improved patient outcomes. LEVEL OF EVIDENCE: Controlled Laboratory Study. BioMed Central 2023-03-07 /pmc/articles/PMC9990317/ /pubmed/36882825 http://dx.doi.org/10.1186/s12891-023-06273-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Muench, Lukas N. Murphey, Matthew Oei, Bridget Kia, Cameron Obopilwe, Elifho Cote, Mark P. Mazzocca, Augustus D. Berthold, Daniel P. Elliptical and spherical heads show similar obligate glenohumeral translation during axial rotation in total shoulder arthroplasty |
title | Elliptical and spherical heads show similar obligate glenohumeral translation during axial rotation in total shoulder arthroplasty |
title_full | Elliptical and spherical heads show similar obligate glenohumeral translation during axial rotation in total shoulder arthroplasty |
title_fullStr | Elliptical and spherical heads show similar obligate glenohumeral translation during axial rotation in total shoulder arthroplasty |
title_full_unstemmed | Elliptical and spherical heads show similar obligate glenohumeral translation during axial rotation in total shoulder arthroplasty |
title_short | Elliptical and spherical heads show similar obligate glenohumeral translation during axial rotation in total shoulder arthroplasty |
title_sort | elliptical and spherical heads show similar obligate glenohumeral translation during axial rotation in total shoulder arthroplasty |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9990317/ https://www.ncbi.nlm.nih.gov/pubmed/36882825 http://dx.doi.org/10.1186/s12891-023-06273-5 |
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