دورية أكاديمية
The Influence of Glenoid Bone Loss and Graft Positioning on Graft and Cartilage Contact Pressures After the Latarjet Procedure.
| العنوان: | The Influence of Glenoid Bone Loss and Graft Positioning on Graft and Cartilage Contact Pressures After the Latarjet Procedure. |
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| المؤلفون: | Ernstbrunner L; Department of Orthopaedic Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia.; Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria, Australia.; Melbourne Orthopaedic Group, Windsor, Victoria, Australia., Robinson DL; Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria, Australia., Huang Y; Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria, Australia., Wieser K; Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland., Hoy G; Melbourne Orthopaedic Group, Windsor, Victoria, Australia., Ek ET; Melbourne Orthopaedic Group, Windsor, Victoria, Australia., Ackland DC; Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria, Australia. |
| المصدر: | The American journal of sports medicine [Am J Sports Med] 2023 Jul; Vol. 51 (9), pp. 2454-2464. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Sage Publications Country of Publication: United States NLM ID: 7609541 Publication Model: Print Cited Medium: Internet ISSN: 1552-3365 (Electronic) Linking ISSN: 03635465 NLM ISO Abbreviation: Am J Sports Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2004- : Thousand Oaks, CA : Sage Publications Original Publication: Baltimore, Williams & Wilkins. |
| مواضيع طبية MeSH: | Bankart Lesions* , Bone Diseases*, Male ; Humans ; Cartilage ; Scapula ; Humerus/surgery |
| مستخلص: | Background: Glenohumeral joint contact loading before and after glenoid bone grafting for recurrent anterior instability remains poorly understood. Purpose: To develop a computational model to evaluate the influence of glenoid bone loss and graft positioning on graft and cartilage contact pressures after the Latarjet procedure. Study Design: Controlled laboratory study. Methods: A finite element model of the shoulder was developed using kinematics, muscle and glenohumeral joint loading of 6 male participants. Muscle and joint forces at 90° of abduction and external rotation were calculated and employed in simulations of the native shoulder, as well as the shoulder with a Bankart lesion, 10% and 25% glenoid bone loss, and after the Latarjet procedure. Results: A Bankart lesion as well as glenoid bone loss of 10% and 25% significantly increased glenoid and humeral cartilage contact pressures compared with the native shoulder ( P < .05). The Latarjet procedure did not significantly increase glenoid cartilage contact pressure. With 25% glenoid bone loss, the Latarjet procedure with a graft flush with the glenoid and the humerus positioned at the glenoid half-width resulted in significantly increased humeral cartilage contact pressure compared with that preoperatively ( P = .023). Under the same condition, medializing the graft by 1 mm resulted in humeral cartilage contact pressure comparable with that preoperatively ( P = .097). Graft lateralization by 1 mm resulted in significantly increased humeral cartilage contact pressure in both glenoid bone loss conditions ( P < .05). Conclusion: This modeling study showed that labral damage and greater glenoid bone loss significantly increased glenoid and humeral cartilage contact pressures in the shoulder. The Latarjet procedure may mitigate this to an extent, although glenoid and humeral contact loading was sensitive to graft placement. Clinical Relevance: The Latarjet procedure with a correctly positioned graft should not lead to increased glenohumeral joint contact loading. The present study suggests that lateral graft overhang should be avoided, and in the situation of large glenoid bone defects, slight medialization (ie, 1 mm) of the graft may help to mitigate glenohumeral joint contact overloading. |
| فهرسة مساهمة: | Keywords: Latarjet procedure; anterior shoulder instability; arthropathy; biomechanics; cartilage contact pressure; finite element analysis; glenoid bone loss |
| تواريخ الأحداث: | Date Created: 20230919 Date Completed: 20230921 Latest Revision: 20231012 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1177/03635465231179711 |
| PMID: | 37724693 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1552-3365 |
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| DOI: | 10.1177/03635465231179711 |