Monday, February 17, 2014

A computer model of a posteriorly augmented glenoid component

Correction of acquired glenoid bone loss in osteoarthritis with a standard versus an augmented glenoid component.

These authors modeled the reconstruction of shoulders with posterior bone deficiency and increased retroversion using a three-dimensional computer surgical simulation. They modeled both a standard glenoid component having a uniform thickness and a posteriorly augmented component.

Their model predicted 4.5 mm more medialization of the joint line with the standard component in comparison to the posteriorly augmented glenoid component. 

Comment: This is a report of a computer simulation. As the authors point out, " The importance of decreasing medialization while correcting excessive glenoid retroversion is not fully understood but may improve joint stability and strength of the shoulder by restoring better tension of the rotator cuff." However, in the actual practice of shoulder arthroplasty in vivo, the tension of the rotator cuff is optimized by the height of the humeral components, which can move the center of rotation to the position where mobility and stability are optimized. A tendency for posterior instability can also be managed by the use of asymmetric humeral head components and rotator interval plication.

To learn more about shoulder arthritis and what can be done about it, see the Shoulder Arthritis Book.

To learn more about the rotator cuff, see the Rotator Cuff Book

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