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Title: Muscle and joint-contact loading at the glenohumeral joint after reverse total shoulder arthroplasty.
Epworth Authors: Richardson, Martin
Other Authors: Ackland, David
Roshan-Zamir, Sasha
Pandy, Marcus
Keywords: Glenohumeral Joint Force
Arthroplasty, Replacement
Compressive Strength
Deltoid Muscle
Joint Instability
Reverse Shoulder Arthroplasty
Muscle Contraction
Postoperative Complications
Prosthesis Failure
Reconstructive Surgical Procedures
Rotator Cuff
Shear Strength
Shoulder Joint
Upper Extremity
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: May-2011
Publisher: Wiley Online Library
Citation: Journal of Orthopaedic Research. 2011 Dec;29(12):1850-1858.
Abstract: The purposes of this study were to determine the contributions of each shoulder muscle to glenohumeral joint force during abduction and flexion in both the anatomical and post-operative shoulder and to identify factors that may contribute to the incidence of glenoid component loosening/failure and joint instability in the shoulder after reverse shoulder arthroplasty (RSA). Eight cadaveric upper extremities were mounted onto a testing apparatus. Muscle lines of action were measured, and muscle forces and muscle contributions to glenohumeral joint forces were determined during abduction and flexion of the pre-operative anatomical shoulder and of the shoulder after arthroplasty. Muscle forces in the middle deltoid during abduction and those in the middle and anterior deltoid during flexion were significantly lower in the reverse shoulder than the pre-operative shoulder (p < 0.017). The resultant glenohumeral joint force in the reverse shoulder was significantly lower than that in the pre-operative shoulder; however, the superior shear force acting at the glenohumeral joint was significantly higher (p < 0.001). Reverse total shoulder arthroplasty reduces muscle effort in performing lifting and pushing tasks; however, reduced joint compressive force has the potential to compromise joint stability, while an increased superior joint shear force may contribute to component loosening/failure. Because greater superior shear force is generated in flexion than in abduction, care should be taken to avoid excessive shoulder loading in this plane of elevation.
DOI: 10.1002/jor.21437
PubMed URL:
ISSN: 0736-0266
Journal Title: Journal of Orthopaedic Research
Type: Journal Article
Affiliated Organisations: Department of Mechanical Engineering, University of Melbourne, Melbourne, Victoria, Australia.
Department of Orthopaedic Surgery, University of Melbourne, Melbourne, Victoria, Australia.
Type of Clinical Study or Trial: Comparative Study
Appears in Collections:Musculoskeletal

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