Stemless reverse shoulder arthroplasty neck shaft angle influences humeral component time-zero fixation and survivorship: a cadaveric biomechanical assessment
Notice bibliographique
Résumé
BackgroundStemless humeral components are being clinically investigated for reverse shoulder arthroplasty (RSA) procedures. There is, however, a paucity of basic science literature on the surgical parameters that influence the success of these procedures. Therefore, this cadaveric biomechanical study evaluated the neck shaft angle (NSA) of implantation on the survivability and performance of stemless RSA humeral components during cyclical loading.MethodsTwelve paired cadaveric humeri were implanted with stemless RSA humeral components at NSAs of 135° and 145°. Implant-bone motion at the periphery of the implant was measured with three optical machine vision USB3 cameras outfitted with c-mount premium lenses and quantified with ProAnalyst® software. A custom three-dimensional loading apparatus was used to cyclically apply three loading directions representative of physiological states at five progressively increasing loading magnitudes. Stemless 135° and 145° implants were compared based on the maximum implant-bone relative distraction detected, as well as the survivorship of the implants throughout the loading protocol.ResultsPrimary fixation and implant biomechanical survivorship were substantially better in the 145° NSA implants. The 135° NSA implants elicited significantly higher implant-bone distractions during cyclical loading (P = 0.001), and implant survivorship was considerably lower in the 135° NSA specimens when compared to the 145° NSA specimens (135° NSA: 0%, 145° NSA: 50%) (P < 0.001).ConclusionsNeck shaft angle is a modifiable parameter that influences time-zero implant stability, as well as the early survivorship of the stemless RSA humeral components tested in this study. Neck shaft angle resections of 145º appear to promote better stability than those utilizing 135º neck shaft angles during early postoperative eccentric loads. Further studies are required to assess if other stemless reversed humeral implant designs have improved time-zero fixation at higher neck-shaft angles. Stemless humeral components are being clinically investigated for reverse shoulder arthroplasty (RSA) procedures. There is, however, a paucity of basic science literature on the surgical parameters that influence the success of these procedures. Therefore, this cadaveric biomechanical study evaluated the neck shaft angle (NSA) of implantation on the survivability and performance of stemless RSA humeral components during cyclical loading. Twelve paired cadaveric humeri were implanted with stemless RSA humeral components at NSAs of 135° and 145°. Implant-bone motion at the periphery of the implant was measured with three optical machine vision USB3 cameras outfitted with c-mount premium lenses and quantified with ProAnalyst® software. A custom three-dimensional loading apparatus was used to cyclically apply three loading directions representative of physiological states at five progressively increasing loading magnitudes. Stemless 135° and 145° implants were compared based on the maximum implant-bone relative distraction detected, as well as the survivorship of the implants throughout the loading protocol. Primary fixation and implant biomechanical survivorship were substantially better in the 145° NSA implants. The 135° NSA implants elicited significantly higher implant-bone distractions during cyclical loading (P = 0.001), and implant survivorship was considerably lower in the 135° NSA specimens when compared to the 145° NSA specimens (135° NSA: 0%, 145° NSA: 50%) (P < 0.001). Neck shaft angle is a modifiable parameter that influences time-zero implant stability, as well as the early survivorship of the stemless RSA humeral components tested in this study. Neck shaft angle resections of 145º appear to promote better stability than those utilizing 135º neck shaft angles during early postoperative eccentric loads. Further studies are required to assess if other stemless reversed humeral implant designs have improved time-zero fixation at higher neck-shaft angles.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».