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Central Fixation Element Type and Size Affect Glenoid Baseplate Micromotion in Reverse Shoulder Arthroplasty.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Central Fixation Element Type and Size Affect Glenoid Baseplate Micromotion in Reverse Shoulder Arthroplasty./
Author:	Torkan, Lawrence F. .
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2021,
Description:	127 p.
Notes:	Source: Masters Abstracts International, Volume: 83-06.
Contained By:	Masters Abstracts International83-06.
Subject:	Osteoarthritis. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28848866
ISBN:	9798759924258

Central Fixation Element Type and Size Affect Glenoid Baseplate Micromotion in Reverse Shoulder Arthroplasty.
Torkan, Lawrence F. .

Central Fixation Element Type and Size Affect Glenoid Baseplate Micromotion in Reverse Shoulder Arthroplasty. - Ann Arbor : ProQuest Dissertations & Theses, 2021 - 127 p.

Source: Masters Abstracts International, Volume: 83-06.

Thesis (M.A.Sc.)--Queen's University (Canada), 2021.

This item must not be sold to any third party vendors.

Reverse shoulder arthroplasty (RSA) is typically performed in patients with injured or deficient rotator cuff muscles. Loosening remains to be one of the principal modes of implant failure and the main complication leading to revision. The objective of this study was to mechanically evaluate factors affecting baseplate fixation to inform clinicians of possible implant configurations that may decrease micromotion and reduce the risk of loosening. Delta XTEND™ baseplates (DePuy Synthes) were implanted into Sawbones™ polyurethane foam blocks (N = 40) and varied in terms of their method of central fixation (screw vs. peg), central length (13.5 vs. 23.5 mm), anterior-posterior peripheral screw type (nonlocking vs. locking), and bone density (10 vs. 25 pcf). Samples were cyclically loaded under compression and shear with a 500 N force at 60° to simulate peak loads during shoulder abduction. Implant-bone motion was measured using four linear variable differential transformers. A theoretical plane was used to interpolate micromotion at the four peripheral screw positions for each sample. Micromotion measurements yielded a mean absolute percentage error (MAPE) of (9.5 ± 2.6)%; average displacements at the implant-bone interface were analyzed with a Kruskal-Wallis H test and nonparametric univariate analysis (α = 0.05). Central peg fixation generated greater micromotion at all four screw positions when compared to central screw fixation (p < 0.001). Furthermore, 13.5 mm central elements generated greater micromotion at all four measurement positions than 23.5 mm samples (p = 0.001). A significant interaction existed between the method of central fixation and central element length at all four screw positions (p < 0.001), as well as between peripheral screw type and bone density at all four screw positions (p = 0.015). Use of a central compression screw and a greater central element length that engages with the cortex of the scapula may provide improved baseplate fixation and reduce interface micromotion. Use of locking screws in the anterior and posterior positions may also offset loss of fixation due to lower bone quality. Future work that considers other baseplate factors may reveal additional surgical considerations and factor interactions.

ISBN: 9798759924258Subjects--Topical Terms:

842035
Osteoarthritis.

Central Fixation Element Type and Size Affect Glenoid Baseplate Micromotion in Reverse Shoulder Arthroplasty.
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245 1 0 $a Central Fixation Element Type and Size Affect Glenoid Baseplate Micromotion in Reverse Shoulder Arthroplasty.
260 1 $a Ann Arbor : $b ProQuest Dissertations & Theses, $c 2021
300 $a 127 p.
500 $a Source: Masters Abstracts International, Volume: 83-06.
500 $a Advisor: Ploeg, Heidi-Lynn.
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506 $a This item must not be sold to any third party vendors.
520 $a Reverse shoulder arthroplasty (RSA) is typically performed in patients with injured or deficient rotator cuff muscles. Loosening remains to be one of the principal modes of implant failure and the main complication leading to revision. The objective of this study was to mechanically evaluate factors affecting baseplate fixation to inform clinicians of possible implant configurations that may decrease micromotion and reduce the risk of loosening. Delta XTEND™ baseplates (DePuy Synthes) were implanted into Sawbones™ polyurethane foam blocks (N = 40) and varied in terms of their method of central fixation (screw vs. peg), central length (13.5 vs. 23.5 mm), anterior-posterior peripheral screw type (nonlocking vs. locking), and bone density (10 vs. 25 pcf). Samples were cyclically loaded under compression and shear with a 500 N force at 60° to simulate peak loads during shoulder abduction. Implant-bone motion was measured using four linear variable differential transformers. A theoretical plane was used to interpolate micromotion at the four peripheral screw positions for each sample. Micromotion measurements yielded a mean absolute percentage error (MAPE) of (9.5 ± 2.6)%; average displacements at the implant-bone interface were analyzed with a Kruskal-Wallis H test and nonparametric univariate analysis (α = 0.05). Central peg fixation generated greater micromotion at all four screw positions when compared to central screw fixation (p < 0.001). Furthermore, 13.5 mm central elements generated greater micromotion at all four measurement positions than 23.5 mm samples (p = 0.001). A significant interaction existed between the method of central fixation and central element length at all four screw positions (p < 0.001), as well as between peripheral screw type and bone density at all four screw positions (p = 0.015). Use of a central compression screw and a greater central element length that engages with the cortex of the scapula may provide improved baseplate fixation and reduce interface micromotion. Use of locking screws in the anterior and posterior positions may also offset loss of fixation due to lower bone quality. Future work that considers other baseplate factors may reveal additional surgical considerations and factor interactions.
590 $a School code: 0283.
650 4 $a Osteoarthritis. $3 842035
650 4 $a Patients. $3 1961957
650 4 $a Surgeons. $3 822890
650 4 $a Transplants & implants. $3 3562683
650 4 $a Arthritis. $3 641465
650 4 $a Shoulder. $3 820037
650 4 $a Trauma. $2 swd $3 1795334
650 4 $a Prostheses. $3 3683608
650 4 $a Hydroxyapatite. $3 669750
650 4 $a Range of motion. $3 3683609
650 4 $a Joint replacement surgery. $3 3562551
650 4 $a Medical research. $2 bicssc $3 1556686
650 4 $a Cartilage. $3 924011
650 4 $a Fractures. $3 823229
650 4 $a Factorial experiments. $3 3691559
650 4 $a Force. $3 3691468
650 4 $a Finite element analysis. $3 3554062
650 4 $a Joint surgery. $3 3691469
650 4 $a Orthopedics. $3 705991
650 4 $a Bone density. $3 3563165
650 4 $a Ligaments. $3 3562651
650 4 $a Biomechanics. $3 548685
650 4 $a Rotator cuff. $3 3691560
650 4 $a Mobility. $3 3557724
650 4 $a Medicine. $3 641104
650 4 $a Surgery. $3 707153
690 $a 0648
690 $a 0564
690 $a 0576
710 2 $a Queen's University (Canada). $3 1017786
773 0 $t Masters Abstracts International $g 83-06.
790 $a 0283
791 $a M.A.Sc.
792 $a 2021
793 $a English
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28848866