Maximizing range of motion of reverse total shoulder arthroplasty using design optimization techniques.
Maximizing range of motion of reverse total shoulder arthroplasty using design optimization techniques.
复制标题
DOI：
10.1016/j.jbiomech.2021.110602
复制
发表时间：
2021-08-26
影响因子：
2.4
通讯作者：
Willing R
中科院分区：
文献类型：
--
作者：
Elwell J;Athwal G;Willing R
反向肩关节置换术 (RSA) 后获得的运动范围 (ROM) 是患者满意度和手术成功的重要因素。目前尚不清楚可最大化 ROM 的最佳 RSA 设计。此外，尚不清楚 RSA 优化的运动包络线（仅与前向平面相比）是否会决定其设计。我们假设这些是潜在的竞争目标（最大化正面仰角平面的活动范围需要牺牲后仰角平面），因此优化的设计会有所不同。本研究的目的是使用计算机模型和设计优化技术来确定针对任一情况优化的 RSA 配置，并在设计和性能方面对它们进行比较。设计参数包括关节盂偏侧、肱骨偏侧、颈轴角、旋转中心下偏移 (COR) 和两种不同的杯深度。所有优化设计都最大限度地提高了关节盂侧化和 COR 的下偏移。然而，专门针对更大的前仰平面 ROM 进行优化的设计具有稍高的颈干角度和更大的肱骨侧化。在性能方面，与具有代表性的市售 Grammot 型假肢相比，优化设计的 ROM 提高了 31% 至 39%。结论是，针对整体与前向平面 ROM 进行优化的 RSA 设计会有所不同，但无论考虑哪个 ROM 区域，两者都比代表性的商用设计有所改进。
Range of motion (ROM) obtained after reverse shoulder arthroplasty (RSA) is an important factor in patient satisfaction and success of the procedure. The optimum RSA design that maximizes ROM is currently unknown. Furthermore, it is unknown if the envelope of motion the RSA is optimized for (overall versus forward elevation planes only) will determine its design. We hypothesized that these were potentially competing objectives (maximizing ROM in frontal elevation planes would require sacrifice in posterior elevation planes), and as a result the optimized designs would differ. The objective of this study was to use computer models and design optimization techniques to determine RSA configurations optimized for either case and compare them in terms of design and performance. Design parameters included glenoid lateralization, humeral lateralization, neck-shaft angle, and inferior offset of the center of rotation (COR) and two different cup depths. All optimized designs maximized glenoid lateralization and inferior offset of the COR. Designs optimized specifically for greater forward elevation plane ROM, however, had slightly higher neck-shaft angles and greater humeral lateralization. In terms of performance, the optimized designs provided 31% to 39% increases in ROM in comparison to that of a representative commercially-available Grammot-style prosthesis. It was concluded that RSA designs optimized for overall versus forward elevation plane ROMs will differ, but both offer improvement over a representative commercially available design, regardless of which ROM region is considered.
登录
查看更多内容
影响因子：
3
作者：
Costantini, Oren;Choi, Daniel S.;Gulotta, Lawrence V.
通讯作者：
Gulotta, Lawrence V.
影响因子：
2.9
作者：
Gates, Deanna H.;Walters, Lisa Smurr;Resnik, Linda
通讯作者：
Resnik, Linda
影响因子：
3
作者：
Schairer, William W.;Nwachukwu, Benedict U.;Gulotta, Lawrence V.
通讯作者：
Gulotta, Lawrence V.
DOI：
10.2106/00004623-198365090-00003
发表时间：
1983-01-01
影响因子：
5.3
作者：
NEER, CS;CRAIG, EV;FUKUDA, H
通讯作者：
FUKUDA, H
DOI：
10.1016/s0883-5403(88)80051-2
发表时间：
1988-01-01
期刊：
The Journal of arthroplasty
影响因子：
--
作者：
Franklin, J L;Barrett, W P;Matsen, F A 3rd
通讯作者：
Matsen, F A 3rd