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  4. Cement stress predictions after anatomic total shoulder arthroplasty are correlated with preoperative glenoid bone quality
 
research article

Cement stress predictions after anatomic total shoulder arthroplasty are correlated with preoperative glenoid bone quality

Terrier, Alexandre  
•
Obrist, Raphael  
•
Becce, Fabio
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2017
Journal Of Shoulder And Elbow Surgery

Hypothesis: We hypothesized that biomechanical parameters typically associated with glenoid implant failure after anatomic total shoulder arthroplasty (aTSA) would be correlated with preoperative glenoid bone quality. Methods: We developed an objective automated method to quantify preoperative glenoid bone quality in different volumes of interest (VOIs): cortical bone, subchondral cortical plate, subchondral bone after reaming, subchondral trabecular bone, and successive layers of trabecular bone. Average computed tomography (CT) numbers (in Hounsfield units [HU]) were measured in each VOI from preoperative CT scans. In parallel, we built patient-specific finite element models of simulated aTSAs to predict cement stress, bone-cement interfacial stress, and bone strain around the glenoid implant. CT measurements and finite element predictions were obtained for 20 patients undergoing aTSA for primary glenohumeral osteoarthritis. We tested all linear correlations between preoperative patient characteristics (age, sex, height, weight, glenoid bone quality) and biomechanical predictions (cement stress, bone-cement interfacial stress, bone strain). Results: Average CT numbers gradually decreased from cortical (717 HU) to subchondral and trabecular (362 HU) bone. Peak cement stress (4-10 MPa) was located within the keel hole, above the keel, or behind the glenoid implant backside. Cement stress, bone-cement interfacial stress, and bone strain were strongly negatively correlated with preoperative glenoid bone quality, particularly in VOIs behind the implant backside (subchondral trabecular bone) but also in deeper trabecular VOIs. Conclusion: Our numerical study suggests that preoperative glenoid bone quality is an important parameter to consider in aTSA, which may be associated with aseptic loosening of the glenoid implant. These initial results should now be confronted with clinical and radiologic outcomes. (C) 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.

  • Details
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Type
research article
DOI
10.1016/j.jse.2017.02.023
Web of Science ID

WOS:000407803300026

Author(s)
Terrier, Alexandre  
Obrist, Raphael  
Becce, Fabio
Farron, Alain
Date Issued

2017

Publisher

Elsevier

Published in
Journal Of Shoulder And Elbow Surgery
Volume

26

Issue

9

Start page

1644

End page

1652

Subjects

Anatomic total shoulder arthroplasty

•

glenoid bone quality

•

computed tomography

•

cement

•

stress

•

finite element

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
LBO  
Available on Infoscience
September 5, 2017
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/140054
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