An Analysis of Variability and Terminology Inconsistencies in the Amount and Type of Constraint in Polyethylene Bearing Liners Across Reverse Shoulder Arthroplasty Implant Systems.

IF 2.9 2区 医学 Q1 ORTHOPEDICS
Daniel Misioura, Shreya Chandra, Andrew Chen, Samuel E Mircoff, Nickolas G Garbis, Dane H Salazar
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Abstract

Introduction: This study aims to evaluate the amount and type of constraint between different Reverse Total Shoulder Arthroplasty (rTSA) systems in order to address a current gap in uniform nomenclature and help guide surgical decision-making in rTSA.

Methods: Data was collected on commercially available polyethylene liners for rTSA implant manufacturers in the United States. Constraint ratios were calculated using liner depth and glenosphere radius, and for select designs, lip heights were used. All available sizes and diameters were analyzed, and data was cross-referenced with published literature and product manuals.

Results: The mean constraint ratio for standard liners was 48.74% (SD = 5.60%), with values ranging from 40% (Medacta Shoulder System) to 62% (Stryker Reunion S). Several devices fell outside one standard deviation from the mean, indicating notable inter-company variability. A one-way ANOVA confirmed significant differences among standard liner designs (p < 0.001). For retentive liners, the mean constraint ratio was 61.90% (SD = 5.24%), ranging from 47% to 71%. Again, multiple devices fell outside the expected range, and ANOVA results demonstrated significant variation across manufacturers (p < 0.001).

Conclusion: Significant variability exists between implant systems when defining "standard" and "retentive" liners in rTSA with calculated constraint ratios. This inconsistency can complicate surgical decisions, especially during revisions or when switching systems, potentially leading to unintended biomechanical outcomes. We advocate for enhanced transparency and standardization by moving away from utilizing the terms "standard" and "retentive" and instead utilizing the implant's neck shaft angle and capture ratio.

反向肩关节置换术植入系统中聚乙烯轴承衬垫约束的数量和类型的可变性和术语不一致分析。
简介:本研究旨在评估不同反向全肩关节置换术(rTSA)系统之间的限制数量和类型,以解决目前在统一命名上的差距,并帮助指导rTSA的手术决策。方法:收集美国rTSA植入物制造商的市售聚乙烯衬垫数据。约束比是用衬垫深度和glenosphere半径计算的,对于某些设计,使用唇高度。分析所有可用的尺寸和直径,并与已发表的文献和产品手册交叉引用数据。结果:标准衬垫的平均约束比为48.74% (SD = 5.60%),其值从40% (Medacta肩部系统)到62% (Stryker Reunion S)不等。有几个设备落在平均值的一个标准差之外,这表明公司之间存在显著的差异。单因素方差分析证实标准线性设计之间存在显著差异(p < 0.001)。固位衬套的平均约束比为61.90% (SD = 5.24%),范围为47% ~ 71%。再次,多个设备落在预期范围之外,方差分析结果显示各制造商之间存在显著差异(p < 0.001)。结论:在计算约束比的rTSA中定义“标准”和“保留”衬垫时,种植体系统之间存在显著差异。这种不一致会使手术决策复杂化,特别是在翻修或切换系统时,可能导致意想不到的生物力学结果。我们提倡提高透明度和标准化,不再使用“标准”和“保留”等术语,而是使用植入物的颈轴角度和捕获比。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.50
自引率
23.30%
发文量
604
审稿时长
11.2 weeks
期刊介绍: The official publication for eight leading specialty organizations, this authoritative journal is the only publication to focus exclusively on medical, surgical, and physical techniques for treating injury/disease of the upper extremity, including the shoulder girdle, arm, and elbow. Clinically oriented and peer-reviewed, the Journal provides an international forum for the exchange of information on new techniques, instruments, and materials. Journal of Shoulder and Elbow Surgery features vivid photos, professional illustrations, and explicit diagrams that demonstrate surgical approaches and depict implant devices. Topics covered include fractures, dislocations, diseases and injuries of the rotator cuff, imaging techniques, arthritis, arthroscopy, arthroplasty, and rehabilitation.
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