Abstract
More than 30 years ago, Neer opined that for shoulder arthroplasty to be successful, it must be considered a soft tissue procedure. Now, present day understanding of the sophisticated biomechanics of the shoulder only further reinforces this concept. The principles of joint stability, biomechanics, and kinematics must be considered, understood and respected in all human joint replacements. This is particularly critical in consideration of shoulder joint arthroplasty because the shoulder has the least intrinsic stability of any human joint and depends primarily on accurate and physiologically correct soft tissue tensions for stability, motion, and function.
Appropriate myofascial sleeve tension, balanced musculoligamentous structures and accurate reproduction of component version are critical to re-establish during shoulder arthroplasty if the surgeon is to reproduce those parameters which insure established biomechanical principals.
Because the shoulder is not weight-bearing, biomechanical principals are often thought to be irrelevant and unimportant. However, the shoulder is very much load-bearing and adherence to the biomechanical principles of muscle length-tension relationships and load transmissions across prosthetic interfaces ensures joint survival, maximal function, and patient satisfaction.
This lecture will review and discuss the most critical biomechanical principles as they relate to replacement arthroplasty of the shoulder. Specifically, the principles will be related to the most recent generations of shoulder implant designs, bone preparation, and cement techniques.
The abstracts were prepared by Mrs Dorothy L. Granchi, Course Coordinator. Correspondence should be addressed to her at PMB 295, 8000 Plaza Boulevard, Mentor, Ohio 44060, USA.
