Development of a Computational Model to Study Instability and Scapular Notching in Reverse Shoulder Arthroplasty

摘要

Reverse shoulder arthroplasty (RSA) is a common treatment for individuals with arthritis of the glenohumeral joint in the presence of a massive rotator cuff tear. Though this procedure has been effective in restoring function to these individuals, it has also been associated with high early to mid-term complications, such as scapular notching and instability.;A finite element (FE) modeling approach has previously been used to study the range of motion an individual with RSA could adduct their arm the polyethylene liner impinged on the inferior scapular bone and the contact stress at the impingement site. This model was then validated in a physical experiment using cadaveric tissue.;In this document, I introduce modifications to that FE model to further study instability and scapular notching risk. First, modern RSA implant geometries were introduced into the model, and the effect of polyethylene liner rotation and glenoid version on impingement-free range of motion and instability risk was assessed. Then, a physical material property characterization of rotator cuff tissues present after RSA was performed. Finally, those material properties and continuum elements representative of the rotator cuff tendons were introduced into the FE model. Throughout all of these studies, greater complexity and fidelity was added to improve the ability to model both contact at the impingement site and potential dislocation events through more accurate loadings and boundary conditions.