Reverse Shoulder Arthroplasty Baseplate Stability Is Affected by Bone Density and the Type and Amount of Augmentation
Objective: This study evaluated the effects of bony increased offset (BIO) and metallic augments (MAs) on primary reverse shoulder arthroplasty (RSA) baseplate stability in cadaveric specimens with variable bone densities. Methods: Thirty cadaveric specimens were analyzed in an imaging and biomechan...
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MDPI AG
2025-01-01
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| author | Daniel Ritter Patric Raiss Patrick J. Denard Brian C. Werner Manuel Kistler Celina Lesnicar Micheal van der Merwe Peter E. Müller Matthias Woiczinski Coen A. Wijdicks Samuel Bachmaier |
| author_facet | Daniel Ritter Patric Raiss Patrick J. Denard Brian C. Werner Manuel Kistler Celina Lesnicar Micheal van der Merwe Peter E. Müller Matthias Woiczinski Coen A. Wijdicks Samuel Bachmaier |
| author_sort | Daniel Ritter |
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| description | Objective: This study evaluated the effects of bony increased offset (BIO) and metallic augments (MAs) on primary reverse shoulder arthroplasty (RSA) baseplate stability in cadaveric specimens with variable bone densities. Methods: Thirty cadaveric specimens were analyzed in an imaging and biomechanical investigation. Computed tomography (CT) scans allowed for preoperative RSA planning and bone density analysis. Three correction methods of the glenoid were used: (1) corrective reaming with a standard baseplate, which served as the reference group (<i>n</i> = 10); (2) MA-RSA (<i>n</i> = 10); and (3) angled BIO-RSA (<i>n</i> = 10). Each augment group consisted of 10° (<i>n</i> = 5) and 20° (<i>n</i> = 5) corrections. Biomechanical testing included cyclic loading in an articulating setup, with optical pre- and post-cyclic micromotion measurements in a rocking horse setup. Results: There were no differences in bone density between groups based on CT scans (<i>p</i> > 0.126). The BIO-RSA group had higher variability in micromotion compared to the MA-RSA and reference groups (<i>p</i> = 0.013), and increased total micromotion compared to the reference group (<i>p</i> = 0.039). Both augmentations using 20° corrections had increased variance in rotational stability compared to the reference group (<i>p</i> = 0.043). Micromotion correlated with the subchondral bone density in the BIO-RSA group (r = −0.63, <i>p</i> = 0.036), but not in the MA-RSA (<i>p</i> > 0.178) or reference (<i>p</i> > 0.117) groups. Conclusions: Time-zero baseplate implant fixation is more variable with BIO-RSA and correlates with bone density. Corrections of 20° with either augmentation approach increase variability in rotational micromotion. The preoperative quantification of bone density may be useful before utilizing 20° of correction, especially when adding a bone graft in BIO-RSAs. |
| format | Article |
| id | doaj-art-f1c079f45ce34bbf81973a522ee261a5 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| series | Bioengineering |
| spelling | doaj-art-f1c079f45ce34bbf81973a522ee261a52025-01-24T13:23:03ZengMDPI AGBioengineering2306-53542025-01-011214210.3390/bioengineering12010042Reverse Shoulder Arthroplasty Baseplate Stability Is Affected by Bone Density and the Type and Amount of AugmentationDaniel Ritter0Patric Raiss1Patrick J. Denard2Brian C. Werner3Manuel Kistler4Celina Lesnicar5Micheal van der Merwe6Peter E. Müller7Matthias Woiczinski8Coen A. Wijdicks9Samuel Bachmaier10Department of Orthopedic Research, Arthrex, 81249 Munich, GermanyOCM Clinic, 81369 Munich, GermanySouthern Oregon Orthopedics, Medford, OR 97504, USADepartment of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA 22908, USADepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, 80336 Munich, GermanyDepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, 80336 Munich, GermanyDepartment of Orthopedic Research, Arthrex, 81249 Munich, GermanyDepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, 80336 Munich, GermanyDepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, 80336 Munich, GermanyDepartment of Orthopedic Research, Arthrex, 81249 Munich, GermanyDepartment of Orthopedic Research, Arthrex, 81249 Munich, GermanyObjective: This study evaluated the effects of bony increased offset (BIO) and metallic augments (MAs) on primary reverse shoulder arthroplasty (RSA) baseplate stability in cadaveric specimens with variable bone densities. Methods: Thirty cadaveric specimens were analyzed in an imaging and biomechanical investigation. Computed tomography (CT) scans allowed for preoperative RSA planning and bone density analysis. Three correction methods of the glenoid were used: (1) corrective reaming with a standard baseplate, which served as the reference group (<i>n</i> = 10); (2) MA-RSA (<i>n</i> = 10); and (3) angled BIO-RSA (<i>n</i> = 10). Each augment group consisted of 10° (<i>n</i> = 5) and 20° (<i>n</i> = 5) corrections. Biomechanical testing included cyclic loading in an articulating setup, with optical pre- and post-cyclic micromotion measurements in a rocking horse setup. Results: There were no differences in bone density between groups based on CT scans (<i>p</i> > 0.126). The BIO-RSA group had higher variability in micromotion compared to the MA-RSA and reference groups (<i>p</i> = 0.013), and increased total micromotion compared to the reference group (<i>p</i> = 0.039). Both augmentations using 20° corrections had increased variance in rotational stability compared to the reference group (<i>p</i> = 0.043). Micromotion correlated with the subchondral bone density in the BIO-RSA group (r = −0.63, <i>p</i> = 0.036), but not in the MA-RSA (<i>p</i> > 0.178) or reference (<i>p</i> > 0.117) groups. Conclusions: Time-zero baseplate implant fixation is more variable with BIO-RSA and correlates with bone density. Corrections of 20° with either augmentation approach increase variability in rotational micromotion. The preoperative quantification of bone density may be useful before utilizing 20° of correction, especially when adding a bone graft in BIO-RSAs.https://www.mdpi.com/2306-5354/12/1/42reverse shoulder arthroplastypreoperative bone densityCT imagingaugmentbaseplateprimary fixation |
| spellingShingle | Daniel Ritter Patric Raiss Patrick J. Denard Brian C. Werner Manuel Kistler Celina Lesnicar Micheal van der Merwe Peter E. Müller Matthias Woiczinski Coen A. Wijdicks Samuel Bachmaier Reverse Shoulder Arthroplasty Baseplate Stability Is Affected by Bone Density and the Type and Amount of Augmentation Bioengineering reverse shoulder arthroplasty preoperative bone density CT imaging augment baseplate primary fixation |
| title | Reverse Shoulder Arthroplasty Baseplate Stability Is Affected by Bone Density and the Type and Amount of Augmentation |
| title_full | Reverse Shoulder Arthroplasty Baseplate Stability Is Affected by Bone Density and the Type and Amount of Augmentation |
| title_fullStr | Reverse Shoulder Arthroplasty Baseplate Stability Is Affected by Bone Density and the Type and Amount of Augmentation |
| title_full_unstemmed | Reverse Shoulder Arthroplasty Baseplate Stability Is Affected by Bone Density and the Type and Amount of Augmentation |
| title_short | Reverse Shoulder Arthroplasty Baseplate Stability Is Affected by Bone Density and the Type and Amount of Augmentation |
| title_sort | reverse shoulder arthroplasty baseplate stability is affected by bone density and the type and amount of augmentation |
| topic | reverse shoulder arthroplasty preoperative bone density CT imaging augment baseplate primary fixation |
| url | https://www.mdpi.com/2306-5354/12/1/42 |
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