Time-elapsed microstructural imaging of failure of the reverse shoulder implant

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dc.contributor.authorMartelli, S.
dc.contributor.authorPerilli, E.
dc.contributor.authorFan, X.
dc.contributor.authorRapagna, S.
dc.contributor.authorGupta, A.
dc.date.issued2024
dc.description.abstractBackground: Reverse Shoulder Arthroplasties (RSA) have become a primary choice for improving shoulder function and pain. However, the biomechanical failure mechanism of the humeral component is still unclear. The present study reports a novel protocol for microstructural imaging of the entire humerus implant under load before and after fracture. Methods: A humerus specimen was obtained from a 75-year-old male donor. An expert surgeon implanted the specimen with a commonly used RSA implant (Aequalis reversed II, Stryker Orthopaedics, USA) and surgical procedure. The physiological glenohumeral contact force that maximized the distal implant migration was selected from a public repository (orthoload.com). Imaging and concomitant mechanical testing were performed using a large-volume micro-CT scanner (Nikon XT H 225 ST) and a custom-made compressive stage. Both when intact and once implanted, the specimen was tested under a pre-load and by imposing a constant deformation causing a physiological reaction load (650 N, 10 degrees adducted). The deformation of the implanted specimen was then increased up to fracture, which was identified by a sudden drop of the reaction force, and the specimen was then re-scanned. Results: The specimen’s stiffness decreased from 874 N/mm to 464 N/mm after implantation, producing movements of the bone-implant interface consistent with the implant’s long-term stability reported in the literature. The micro-CT images displayed fracture of the tuberosity, caused by a combined compression and circumferential tension, induced by the distal migration of the implant. Conclusion: The developed protocol offers detailed information on implant mechanics under load relative to intact conditions and fracture, providing insights into the failure mechanics of RSA implants. This protocol can be used to inform future implant design and surgical technique improvements.
dc.description.statementofresponsibilitySaulo Martelli, Egon Perilli, Xiaolong Fan, Sophie Rapagna, and Ashish Gupta
dc.identifier.citationJournal of Orthopaedic Surgery and Research, 2024; 19(1):180-1-180-12
dc.identifier.doi10.1186/s13018-024-04652-9
dc.identifier.issn1749-799X
dc.identifier.issn1749-799X
dc.identifier.urihttps://hdl.handle.net/2440/147687
dc.language.isoen
dc.publisherBMC
dc.relation.granthttp://purl.org/au-research/grants/arc/LE180100136
dc.relation.granthttp://purl.org/au-research/grants/arc/FT180100338
dc.relation.granthttp://purl.org/au-research/grants/arc/IC190100020
dc.rights© Crown 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
dc.source.urihttp://dx.doi.org/10.1186/s13018-024-04652-9
dc.subjectReverse shoulder arthroplasty; Implant failure; Bone microstructural imaging; Biomechanics
dc.subject.meshUpper Extremity
dc.subject.meshShoulder
dc.subject.meshHumerus
dc.subject.meshShoulder Joint
dc.subject.meshHumans
dc.subject.meshRange of Motion, Articular
dc.subject.meshProsthesis Design
dc.subject.meshAged
dc.subject.meshMale
dc.subject.meshFractures, Bone
dc.titleTime-elapsed microstructural imaging of failure of the reverse shoulder implant
dc.typeJournal article
pubs.publication-statusPublished

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