Biomechanical research progress of the Grammont prosthesis and its derivative reverse shoulder prostheses
10.3760/cma.j.cn121113-20240111-00031
- VernacularTitle:Grammont假体及其衍生反肩关节假体的生物力学研究进展
- Author:
Jiong YU
1
;
Wenxuan CHEN
;
Jingyi MI
Author Information
1. 苏州大学附属无锡市第九人民医院运动医学科，无锡 214000
- Keywords:
Shoulder prosthesis;
Arthroplasty, replacement, shoulder;
Review
- From:
Chinese Journal of Orthopaedics
2024;44(18):1239-1245
- CountryChina
- Language:Chinese
-
Abstract:
Reverse shoulder arthroplasty is an effective method for treating end-stage degenerative shoulder diseases and severe shoulder trauma. Early researchers found that complications such as acromial fracture, inferior glenohumeral impingement, and external rotation limitation may occur during the use of reverse shoulder prosthesis. Additionally, during shoulder joint movements, the shear forces between the bone-implant (glenoid-baseplate) interface increase, leading to a higher risk of prosthesis loosening and dislocation. In order to reduce the incidence of complications after reverse shoulder arthroplasty, the modified reverse shoulder prosthesis was developed, and a variety of prostheses were derived from it. The main direction of improvement was to shift the rotation center of the prosthesis system. The center of rotation for external displacement can be set on the glenoid side of the scapula, the humeral side, or both sides simultaneously modified. Modified prostheses can be classified according to the site of external translation and the size of the humeral offset. The stability and movement ability of the reverse shoulder prosthesis depend on the deltoid muscle. Even if the rotator cuff is injured, it does not affect the shoulder joint movement, so the patient's postoperative satisfaction is high. Through the non-anatomical design of a fixed rotation center, a semi-restrictive stable structure is formed, and the implant geometry can form a more stable joint between the humeral head and the glenoid, reducing the incidence of glenoid prosthesis loosening and implant failure. Reverse shoulder arthroplasty is not suitable for all patients. For patients without significant rotator cuff dysfunction, forward shoulder arthroplasty is still the preferred surgical procedure to restore the natural anatomy and shoulder kinematics. Surgeons should conduct a comprehensive analysis of the patient's functional status, needs, and individual anatomy to determine the optimal surgical approach.
