Huang Yichen, Ernstbrunner Lukas, Robinson Dale L, Lee Peter Vee Sin, Ackland David C
Department of Biomedical Engineering, University of Melbourne, Parkville, VIC 3010, Australia.
Department of Orthopaedic Surgery, Royal Melbourne Hospital, Parkville, VIC 3050, Australia.
J Clin Med. 2021 Nov 16;10(22):5336. doi: 10.3390/jcm10225336.
Reverse total shoulder arthroplasty (RTSA) is an established treatment for elderly patients with irreparable rotator cuff tears, complex proximal humerus fractures, and revision arthroplasty; however, with the increasing indications for RTSA over the last decade and younger implant recipients, post-operative complications have become more frequent, which has driven advances in computational modeling and simulation of reverse shoulder biomechanics. The objective of this study was to provide a review of previously published studies that employed computational modeling to investigate complications associated with RTSA. Models and applications were reviewed and categorized into four possible complications that included scapular notching, component loosening, glenohumeral joint instability, and acromial and scapular spine fracture, all of which remain a common cause of significant functional impairment and revision surgery. The computational shoulder modeling studies reviewed were primarily used to investigate the effects of implant design, intraoperative component placement, and surgical technique on postoperative shoulder biomechanics after RTSA, with the findings ultimately used to elucidate and mitigate complications. The most significant challenge associated with the development of computational models is in the encapsulation of patient-specific anatomy and surgical planning. The findings of this review provide a basis for future direction in computational modeling of the reverse shoulder.
反式全肩关节置换术（RTSA）是治疗老年患者不可修复的肩袖撕裂、复杂的肱骨近端骨折和翻修关节置换术的既定方法；然而，在过去十年中，随着RTSA适应症的增加以及植入物接受者的年轻化，术后并发症变得更加频繁，这推动了反式肩关节生物力学计算建模和模拟的进展。本研究的目的是对先前发表的采用计算建模来研究与RTSA相关并发症的研究进行综述。对模型和应用进行了综述，并将其分为四种可能的并发症，包括肩胛切迹、组件松动、盂肱关节不稳定以及肩峰和肩胛冈骨折，所有这些仍然是导致严重功能障碍和翻修手术的常见原因。所综述的计算肩关节建模研究主要用于研究植入物设计、术中组件放置和手术技术对RTSA术后肩关节生物力学的影响，其结果最终用于阐明和减轻并发症。与计算模型开发相关的最重大挑战在于患者特异性解剖结构和手术规划的封装。本综述的结果为反式肩关节计算建模的未来方向提供了基础。
