Nikolas K Knowles1, Louis M Ferreira1, George S Athwal2. 1. Roth|McFarlane Hand and Upper Limb Centre, Bioengineering Laboratory, St. Joseph's Health Care, London, ON, Canada; Department of Mechanical and Materials Engineering, University of Western Ontario, London, ON, Canada. 2. Roth|McFarlane Hand and Upper Limb Centre, Bioengineering Laboratory, St. Joseph's Health Care, London, ON, Canada. Electronic address: gathwal@uwo.ca.
Abstract
BACKGROUND: The purpose of this computational modeling study was to compare the volume of glenoid bone removal required to implant 3 augmented component designs for management of B2 erosions. In addition, we assessed bone quality of the supporting bone directly beneath the implants by measuring bone density and porosity. METHODS: Three augmented component designs—full-wedge, posterior-wedge, and posterior-step—were studied by virtual implantation in a cohort of 16 patients with B2 glenoids. B2 retroversion was corrected to 0° and 10°. The outcome variables were the volume of glenoid bone removal required for implantation and the density and porosity of the bone immediately beneath the implant. RESULTS: Implant design had a significant effect on the volume of bone removal (P < .001). When correcting to 0°, the posterior-wedge implant removed less bone than the posterior-step (P < .001) and the full-wedge (P = .004). At 10° retroversion, the posterior-wedge removed less bone (P = .029) than the posterior-step but was no different than the full-wedge (P = .143). The residual glenoid bone density with the posterior-wedge was significantly greater than with the posterior-step (P = .048), with no other significant differences (P > .05). Residual glenoid bone porosity was not significantly different between implants (P > .262). CONCLUSIONS: Augmented components can provide a bone-preserving option for B2 glenoid management. Substantial variations in the volume of bone removal and the quality of the remaining glenoid bone were found between 3 different designs of augmented implants. Simulations with the posterior-wedge implant resulted in substantially less glenoid bone removal, with the remaining supporting bone being of better quality.
BACKGROUND: The purpose of this computational modeling study was to compare the volume of glenoid bone removal required to implant 3 augmented component designs for management of B2 erosions. In addition, we assessed bone quality of the supporting bone directly beneath the implants by measuring bone density and porosity. METHODS: Three augmented component designs—full-wedge, posterior-wedge, and posterior-step—were studied by virtual implantation in a cohort of 16 patients with B2 glenoids. B2 retroversion was corrected to 0° and 10°. The outcome variables were the volume of glenoid bone removal required for implantation and the density and porosity of the bone immediately beneath the implant. RESULTS: Implant design had a significant effect on the volume of bone removal (P < .001). When correcting to 0°, the posterior-wedge implant removed less bone than the posterior-step (P < .001) and the full-wedge (P = .004). At 10° retroversion, the posterior-wedge removed less bone (P = .029) than the posterior-step but was no different than the full-wedge (P = .143). The residual glenoid bone density with the posterior-wedge was significantly greater than with the posterior-step (P = .048), with no other significant differences (P > .05). Residual glenoid bone porosity was not significantly different between implants (P > .262). CONCLUSIONS: Augmented components can provide a bone-preserving option for B2 glenoid management. Substantial variations in the volume of bone removal and the quality of the remaining glenoid bone were found between 3 different designs of augmented implants. Simulations with the posterior-wedge implant resulted in substantially less glenoid bone removal, with the remaining supporting bone being of better quality.
Authors: Alexander W Aleem; Nathan D Orvets; Brendan C Patterson; Aaron M Chamberlain; Jay D Keener Journal: Clin Orthop Relat Res Date: 2018-08 Impact factor: 4.176
Authors: Xiang Chen; Akhil S Reddy; Andreas Kontaxis; Daniel S Choi; Timothy Wright; David M Dines; Russell F Warren; Julien Berhouet; Lawrence V Gulotta Journal: Clin Orthop Relat Res Date: 2017-09-25 Impact factor: 4.176