Scapular morphology variation affects reverse total shoulder arthroplasty biomechanics. A predictive simulation study using statistical and musculoskeletal shoulder models
| dc.contributor.author | Silvestros, Pavlos | |
| dc.contributor.author | Athwal, George S. | |
| dc.contributor.author | Giles, Joshua | |
| dc.date.accessioned | 2024-03-22T17:33:05Z | |
| dc.date.available | 2024-03-22T17:33:05Z | |
| dc.date.issued | 2024 | |
| dc.description.abstract | Reverse total shoulder arthroplasty (RTSA) accounts for over half of shoulder replacement surgeries. At present, the optimal position of RTSA components is unknown. Previous biomechanical studies have investigated the effect of construct placement to quantify mobility, stability and functionality postoperatively. While studies have provided valuable information on construct design and surgical placement, they have not systematically evaluated the importance of scapular morphology on biomechanical outcomes. The aim of this study was to assess the influence of scapular morphology variation on RTSA biomechanics using statistical models, musculoskeletal modeling and predictive simulation. The scapular geometry of a musculoskeletal model was altered across six modes of variation at four levels (±1 and ±3 SD) from a clinically derived statistical shape model. For each model, a standardized virtual surgery was performed to place RTSA components in the same relative position on each model then implemented in 50 predictive simulations of upward and lateral reaching tasks. Results showed morphology affected functional changes in the deltoid moment arms and recruitment for the two tasks. Variation of the anatomy that reduced the efficiency of the deltoids showed increased levels of muscle force production, joint load magnitude and shear. These findings suggest that scapular morphology plays an important role in postoperative biomechanical function of the shoulder with an implanted RTSA. Furthermore a “one-size-fits-all” approach for construct surgical placement may lead to suboptimal patient outcomes across a clinical population. Patient glenoid as well as scapular anatomy may need to be carefully considered when planning RTSA to optimize postoperative success. | |
| dc.description.reviewstatus | Reviewed | |
| dc.description.scholarlevel | Faculty | |
| dc.description.sponsorship | This study was funded by the Canadian Institutes of Health Research and through the Michael Smith Health Research British Columbia Scholar Award. | |
| dc.identifier.citation | Silvestros, P., Athwal, G. S., & Giles, J. W. (2024). Scapular morphology variation affects reverse total shoulder arthroplasty biomechanics. A predictive simulation study using statistical and musculoskeletal shoulder models. Journal of Orthopaedic Research. https://doi.org/10.1002/jor.25801 | |
| dc.identifier.uri | https://doi.org/10.1002/jor.25801 | |
| dc.identifier.uri | https://hdl.handle.net/1828/16277 | |
| dc.language.iso | en | |
| dc.publisher | Journal of Orthopaedic Research | |
| dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 International | en |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
| dc.subject | musculoskeletal model | |
| dc.subject | predictive simulations | |
| dc.subject | reverse total shoulder arthroplasty | |
| dc.subject | virtual surgery and statistical shape model | |
| dc.subject.department | Department of Mechanical Engineering | |
| dc.title | Scapular morphology variation affects reverse total shoulder arthroplasty biomechanics. A predictive simulation study using statistical and musculoskeletal shoulder models | |
| dc.type | Article |