Stress shielding and bone resorption in shoulder arthroplasty

被引:577
|
作者
Nagels, J [1 ]
Stokdijk, M [1 ]
Rozing, PM [1 ]
机构
[1] Leiden Univ, Med Ctr, Dept Orthopaed, Orthopaed Lab, NL-2300 RC Leiden, Netherlands
关键词
D O I
10.1067/mse.2003.22
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
The radiographs of 64 patients with 70 humeral head replacements were reviewed for signs of stress shielding. Of these, 49 were implanted for rheumatoid arthritis and 21 for osteoarthritis. The radiographic follow-up averaged 5.3 years. Measurements of cortex thickness were performed in 4 regions along the stem of the implant, and the differences between the postoperative radiograph and the radiograph at follow-up were calculated. The size of the stem in relation to the diameter of the humerus was calculated with the use of validated measures, resulting in the relative stem size. In 6 patients (9%) a significant reduction in cortical thickness was observed in the proximal-lateral region of the humeral stem, 5 in rheumatoid patients and I in an osteoarthritic patient. In the stress shielding group, the relative stem size was found to be significantly higher than that in the non-stress shielding group (0.58 vs 0.48). Osteoporosis, especially present in rheumatoid arthritis, could well be a risk factor. It was concluded that stress shielding is a long-term complication of shoulder arthroplasty and that the relative stem size is an important factor in its genesis.
引用
收藏
页码:35 / 39
页数:5
相关论文
共 50 条
  • [1] Bone resorption in shoulder arthroplasty
    Nagels, J
    Stokdijk, M
    Rozing, PM
    PROCEEDINGS OF THE THIRD CONFERENCE OF THE INTERNATIONAL SHOULDER GROUP, 2001, : 80 - 82
  • [2] Effect of stress-shielding-induced bone resorption on glenoid loosening in reverse total shoulder arthroplasty
    Zhang, Min
    Gregory, Thomas
    Hansen, Ulrich
    Cheng, Cheng-Kung
    JOURNAL OF ORTHOPAEDIC RESEARCH, 2020, 38 (07) : 1566 - 1574
  • [3] Stress shielding in stemmed reverse shoulder arthroplasty: an updated review
    Vasiliadis, Angelo V.
    Giovanoulis, Vasileios
    Lepidas, Nikolaos
    Bampis, Ioannis
    Servien, Elvire
    Lustig, Sebastien
    Gunst, Stanislas
    SICOT-J, 2024, 10
  • [4] Stress shielding following stemless anatomic total shoulder arthroplasty
    Aibinder, William R.
    Uddin, Fares
    Bicknell, Ryan T.
    Krupp, Ryan
    Scheibel, Markus
    Athwal, George S.
    SHOULDER & ELBOW, 2023, 15 (01) : 54 - 60
  • [5] Stress shielding of the proximal humerus in stemless anatomic total shoulder arthroplasty
    Rankin, Iain A.
    Goffin, Joaquim
    Khan, L. A. Kash
    Cairns, David
    Barker, Scott L.
    Kumar, Kapil
    SHOULDER & ELBOW, 2024, 16 (05) : 493 - 500
  • [6] Humeral bone resorption after anatomic shoulder arthroplasty using an uncemented stem
    Inoue, Kazuya
    Suenaga, Naoki
    Oizumi, Naomi
    Yamaguchi, Hiroshi
    Miyoshi, Naoki
    Taniguchi, Noboru
    Munemoto, Mitsuru
    Egawa, Takuya
    Tanaka, Yasuhito
    JOURNAL OF SHOULDER AND ELBOW SURGERY, 2017, 26 (11) : 1984 - 1989
  • [7] Stress-shielding induced bone remodeling in cementless shoulder resurfacing arthroplasty: a finite element analysis and in vivo results
    Schmidutz, F.
    Agarwal, Y.
    Mueller, P. E.
    Gueorguiev, B.
    Richards, R. G.
    Sprecher, C. M.
    JOURNAL OF BIOMECHANICS, 2014, 47 (14) : 3509 - 3516
  • [8] Effectiveness of CT for the detection of glenoid bone graft resorption following reverse shoulder arthroplasty
    Ferreira, L. M.
    Knowles, N. K.
    Richmond, D. N.
    Athwal, G. S.
    ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH, 2015, 101 (04) : 427 - 430
  • [9] Patterns of proximal humeral bone resorption after total shoulder arthroplasty with an uncemented rectangular stem
    Spormann, Christoph
    Durchholz, Holger
    Audige, Laurent
    Flury, Matthias
    Schwyzer, Hans-Kaspar
    Simmen, Beat R.
    Kolling, Christoph
    JOURNAL OF SHOULDER AND ELBOW SURGERY, 2014, 23 (07) : 1028 - 1035
  • [10] Medial calcar bone resorption after anatomic total shoulder arthroplasty: does it affect outcomes?
    DeVito, Paul
    Judd, Hyrum
    Malarkey, Andy
    Elson, Leah
    McNeely, Emmanuel
    Berglund, Derek
    Vakharia, Rushabh
    Levy, Jonathan C.
    JOURNAL OF SHOULDER AND ELBOW SURGERY, 2019, 28 (11) : 2128 - 2138