Nyffeler Richard W, Sheikh Ralph, Atkinson Todd S, Jacob Hilaire A C, Favre Philippe, Gerber Christian
Department of Orthopaedics, University of Zurich, Balgrist Hospital, Zurich, Switzerland.
J Shoulder Elbow Surg. 2006 Sep-Oct;15(5):625-9. doi: 10.1016/j.jse.2005.09.016.
The purpose of this study was to determine whether changes in glenoid version are associated with humeral head displacement and changes in the joint reaction forces, as these might contribute to instability or loosening in total shoulder replacement. A total shoulder prosthesis was implanted in neutral version in 6 cadaveric shoulders. Glenoid version was then changed in steps of 4 degrees toward more anteversion and retroversion. An increase in anteversion resulted in anterior translation of the humeral head and in eccentric loading of the anterior part of the glenoid. Retroversion was associated with posterior displacement and posterior loading of the glenoid. A change in rotation of the humeral component did not compensate for altered version of the glenoid component. These results suggest that both instability and glenoid component loosening may be related to the version of the glenoid component. Therefore, assessment of loosening and instability justifies precise assessment of glenoid component version.
本研究的目的是确定肩胛盂版本的变化是否与肱骨头移位及关节反应力的变化相关,因为这些可能导致全肩关节置换术的不稳定或松动。在6具尸体肩部以中立版本植入全肩关节假体。然后将肩胛盂版本以4度的步长逐步改变为更多的前倾角和后倾角。前倾角增加导致肱骨头向前移位以及肩胛盂前部的偏心负荷。后倾角增加则与肱骨头向后移位及肩胛盂后部负荷相关。肱骨组件旋转的改变并不能补偿肩胛盂组件版本的改变。这些结果表明,不稳定和肩胛盂组件松动都可能与肩胛盂组件的版本有关。因此,对松动和不稳定的评估需要精确评估肩胛盂组件的版本。