Varying degrees of posterior glenoid bone loss occurs in patients with end stage osteoarthritis and can result in increased glenoid retroversion. The excessive retroversion can affect implant stability, eccentric glenoid loading, and fixation stresses. Ultimately, the goal is to correct retroversion to restore normal biomechanics of the glenohumeral joint. The objective of this study was to identify the optimal augmented glenoid design based on finite element analysis (FEA) modeling which will provide key insights into implant loosening mechanisms and stability. Two different augmented glenoid designs, posterior wedge and posterior step- were created as a computer model by a computer aided design software (CAD). These implant CAD models were created per precise manufacturers dimensions and sizes of the augmented implant designs. These implants were virtually implanted to correct 20° glenoid retroversion and the different mechanical parameters were calculated including: the glenohumeral subluxation force, relative micromotion at the bone-cement interface the glenoid, implant and cement mantle stress levels. The FEA model was then utilized to make measurements while the simulating abduction with the different implant designs. The biomechanical response parameters were compared between the models at comparable retroversion correction.Introduction
Materials and Methods
Augmented glenoid implants provide a new avenue to correct glenoid bone loss and can possibly reconcile current prosthetic failures and improve long-term performance. Biomechanical implant studies have suggested benefits from augmented glenoid components but limited evidence exists on optimal design of these augmented glenoid components. The aim of this study was to use integrated kinematic finite element analysis (FEA) model to evaluate the optimal augmented glenoid design based on biomechanical performance in extreme conditions for failure. Computer aided design software (CAD) models of two different commercially available augmented glenoid designs - wedge (Equinox®, Exactech, Inc.) and step (Steptech®, Depuy Synthes) were created per precise manufacturer's dimensions and sizes of the implants. Using FE modeling, these implants were virtually implanted to correct 20° of glenoid retroversion. Two glenohumeral radial mismatches (RM) (3.5/4mm and 10 mm) were evaluated for joint stability and implant fixation to simulate high risk conditions for failure. The following variables were recorded: glenohumeral force ratio, relative micromotion (distraction, translation and compression), and stress on the implant and at the cement mantle interface.Introduction
Materials and Methods
Varying degrees of posterior glenoid bone loss occurs in patients with end stage osteoarthritis and can result in increased glenoid retroversion. Ultimately, the goal is to correct retroversion to restore normal biomechanics of the glenohumeral joint. The goal of this study was to identify the optimal augmented glenoid design based on finite element model analysis which will provide key insights into implant loosening mechanisms and stability. Two different augmented glenoid designs, posterior wedge and posterior step- were created as a computer model by a computer aided design software (CAD). These implants were virtually implanted to correct 20° glenoid retroversion and the different mechanical parameters were calculated including: the glenohumeral contact pressure, the cement stress, the shear stress, and relative micromotions at the bone cement interface.Introduction
Materials and Methods