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Assessment of intraoperative joint loads and mobility in reverse total shoulder arthroplasty through a humeral trial sensor

      Abstract

      Hypothesis

      The use of intraoperative glenohumeral load sensors has the potential to facilitate an objective, quantitative assessment of the soft tissue tension during reverse total shoulder arthroplasty.

      Material and Methods

      A reverse total shoulder arthroplasty was performed on eight fresh frozen cadaveric shoulders, creating three different tightness conditions for each shoulder by using various shim thicknesses attached to an instrumented, load-sensing humeral trial component. The glenohumeral loads were recorded during four dynamic maneuvers, consisting of maximum internal/external rotation at 0°, 45° and 90° abduction and forward elevation. The joint kinematics were synchronously recorded using an optical tracking system.

      Results

      For normal tightness conditions, 98.3% of the observed loads were below 40 lbf. These loads varied through the range of motion with an increase in glenohumeral loads generally observed towards the limits of the range of motion. With increasing shoulder tightness, the range of motion of the joint was not significantly affected, though the average and maximum glenohumeral load significantly increased (p < 0.01 for all).

      Conclusion

      In a cadaveric setting, higher glenohumeral loads were observed at higher tightness conditions, demonstrating the potential of a load-sensing humeral trial component to quantify intraoperative joint load with reverse total shoulder arthroplasty. The glenohumeral loads are increasing towards the limits of the range of motion, indicating the importance of performing dynamic assessment of stability at the extents of the range of motion during implant trialing.

      Level of Evidence

      Basic Science Study

      Keywords

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