Influence of implant design and parasagittal acromial morphology on acromial and scapular spine strain after reverse total shoulder arthroplasty: a cadaveric and computer-based biomechanical analysis.

Journal of Shoulder and Elbow Surgery
Sarav S ShahLawrence V Gulotta

Abstract

The purpose was to analyze the influence of deltoid lengthening due to different implant designs and anatomic variations of the acromion and scapular spine (SS) in the parasagittal plane on strain patterns after reverse shoulder arthroplasty (RSA). Ten cadaveric shoulders with strain rosettes placed on the surface of the acromial body (Levy II) and SS (Levy III) were tested using a shoulder simulator. RSA using humeral onlay (+3, +5, +8, +10, +13 mm) and glenosphere lateralization (0, +6 mm) was performed. Arm lengthening and magnitude of strain on acromion/SS were measured. The length of deltoid was assessed using validated computer modeling. Anatomic variance of the SS angle and position of acromion in relation to the scapular plane was examined. For comparison of strain as a function of deltoid lengthening, 25 mm was used as a threshold value for comparison based on previous literature demonstrating a decrease in Constant score and active anterior elevation in patients with arm lengthening >25 mm. At maximal deltoid lengthening (30.8 mm), average strains were 1112 με (acromion) and 1165 με (SS) (P < .01). There was an 82.6% increase in acromial strain at maximum lengthening compared with 25 mm (P = .02) and a strain increase...Continue Reading

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Citations

Mar 8, 2021·Journal of Shoulder and Elbow Surgery·UNKNOWN ASES Complications of RSA Research Group:Andrew Jawa
Jun 1, 2021·The Orthopedic Clinics of North America·Eileen M CollitonJacob M Kirsch

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