A Computational Investigation Into Acromial Fractures After Reverse Total Shoulder Arthroplasty

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Abstract and keywords

Acromial fractures are a debilitating complication following reverse total shoulder arthroplasty (RTSA). The purpose of this work is to (1) improve the current state of FE bone stress estimates after RTSA and to investigate the effects of (2) plane of elevation, (3) hand loads, and (4) baseplate screw position on scapular spine stress. The FE method used was validated against an in-vitro strain gauge based experiment and found to be accurate in the prediction of stress increases and decreases after RTSA. The coronal plane of elevation was found to increase scapular spine stress compared to more central planes of elevation. Hand load increased stress levels above the fatigue threshold of healthy cortical bone. A divergent screw angle decreased bone stress and if the screw penetrated the scapular spine then leaving the screw in place decreased bone stress compared to withdrawal. This work can help in determining the optimal surgical protocol.

Keywords: Reverse total shoulder arthroplasty; acromial fractures; biomechanics; finite element analysis; implant placement; bone stress/strain

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Cited By (1)

Year	Entry
2023	Ferguson D. A Biomechanical Comparison of a Subacromial Balloon Spacer, Superior Capsular Reconstruction, and a Rigid Subacromial Spacer in a Massive Irreparable Rotator Cuff Cadaveric Model [Master's thesis]. University of Western Ontario; 2023.