Humeral short stem varus-valgus alignment affects bone stress.

Autor: Tavakoli A; Department of Mechanical and Materials Engineering, The University of Western Ontario, London, Ontario, Canada.; Roth McFarlane Hand and Upper Limb Center, St. Joseph's Health Care London, London, Ontario, Canada., Spangenberg G; Department of Mechanical and Materials Engineering, The University of Western Ontario, London, Ontario, Canada.; Roth McFarlane Hand and Upper Limb Center, St. Joseph's Health Care London, London, Ontario, Canada., Reeves JM; Department of Mechanical and Materials Engineering, The University of Western Ontario, London, Ontario, Canada.; Roth McFarlane Hand and Upper Limb Center, St. Joseph's Health Care London, London, Ontario, Canada., Faber KJ; Department of Mechanical and Materials Engineering, The University of Western Ontario, London, Ontario, Canada.; Roth McFarlane Hand and Upper Limb Center, St. Joseph's Health Care London, London, Ontario, Canada., Langohr GDG; Department of Mechanical and Materials Engineering, The University of Western Ontario, London, Ontario, Canada.; Roth McFarlane Hand and Upper Limb Center, St. Joseph's Health Care London, London, Ontario, Canada.
Jazyk: angličtina
Zdroj: Journal of orthopaedic research : official publication of the Orthopaedic Research Society [J Orthop Res] 2022 Sep; Vol. 40 (9), pp. 2169-2178. Date of Electronic Publication: 2021 Dec 16.
DOI: 10.1002/jor.25239
Abstrakt: The use of uncemented humeral stems in total shoulder arthroplasty (TSA) is associated with stress shielding. Shorter length stems have shown to decrease stress shielding; however, the effect of stem varus-valgus alignment is currently not known. The purpose of this study was to quantify the effect of short stem distal humeral endosteal contact due to varus-valgus angulation on bone stresses after TSA. Three-dimensional models of eight male cadaveric humeri were constructed from computed tomography data. Bone models were reconstructed with a short stem humeral component implant in three positions (standard, varus, and valgus). Modeling was performed at 45° and 75° of abduction and the resulting differentials in bone stress compared to the intact state and the expected time-zero bone response were determined. In cortical and trabecular bone, the standard position (STD) altered bone stress less than the valgus (VAL) and varus (VAR) positions relative to the intact state. For both cortical (p = 0.033) and trabecular (p = 0.012) bone, the VAL position produced a larger volume of bone with resorbing potential compared to the STD position.
(© 2021 Orthopaedic Research Society. Published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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