Development of shoulder arthroplasty mr s bale
•
8 likes•3,057 views
Development of shoulder arthroplasty
Recommended
More Related Content
What's hot
What's hot (20)
Viewers also liked
Viewers also liked (20)
More from Wrightington Upper Limb Unit
More from Wrightington Upper Limb Unit (10)
Recently uploaded
Recently uploaded (20)
Development of shoulder arthroplasty mr s bale
- 1. Shoulder Arthroplasty Implants - Origins and Developmennt Mr Steve Bale FRCS(Orth) Fellows Teaching 26/9/14
- 2. Jules Pean 1893 Fellows Teaching 26/9/14
- 3. Fellows Teaching 26/9/14 “.... a virtuoso of the knife, who amputates three legs and two arms in quick succession, dismantles a couple of shoulders, trepans five crania, takes out half a dozen wombs and cuts off a few testicles. He works like this for about two hours. He is dripping with blood and sweat. His feet stand in pools of blood.” Léon Daudet
- 4. Charles Neer Fellows Teaching 26/9/14
- 5. Charles Neer • Neer CS Am J Surg 1955;901-7 • Neer CS J Bone Joint Surg 1970;1090-1103 • Neer CS J Bone Joint Surg 1974;1-13 Fellows Teaching 26/9/14
- 6. Fellows Teaching 26/9/14 Hemiarthroplasty Total Shoulder Replacement
- 7. Neer Prostheses Fellows Teaching 26/9/14
- 8. • Monobloc prostheses • Limited stem options • Fixed neck angle • No offset Fellows Teaching 26/9/14
- 9. Shoulder Arthroplasty Fellows Teaching 26/9/14 Good cuff No cuff
- 10. Charles Neer Fellows Teaching 26/9/14 “In the future…the basic design of the articular surfaces should remain the same as normal anatomy. No biomechanical theory can improve on anatomical design.”
- 11. Fellows Teaching 26/9/14 Cuff deficient shoulders Reverse Designs Semi-constrained Big Heads Bipolar
- 13. Bi-polar Arthroplasty Fellows Teaching 26/9/14
- 14. Big Head Fellows Teaching 26/9/14
- 15. Fellows Teaching 26/9/14 JBJS 1982; 47-51
- 18. Paul Grammont Fellows Teaching 26/9/14
- 22. Biomechanics • Large glenosphere with no neck • Small humeral cup covering less than half of the glenosphere • Non-anatomomic inclination of 155 deg • Medialise COR • Minimises torque on glenoid component • Recruits more deltoid fibres • Lowers humerus tensioning deltoid Fellows Teaching 26/9/14
- 24. Evidence • Siveaux et al, JBJS 2004; 86B: 388-395 • Guery et al, JBJS 2006; 88A: 1742-1747 • Favard et al, Clin Orth; 2011; 469: 2469-2475 • Implant survival 90+ % 10 years Fellows Teaching 26/9/14
- 25. Giles Walch Fellows Teaching 26/9/14
- 26. Pascal Boileau Fellows Teaching 26/9/14
- 27. Modularity Fellows Teaching 26/9/14 Boileau JBJS Br 1997: 857 65
- 28. Fellows Teaching 26/9/14 Hemiarthroplasty Total Shoulder Replacement Wirth JBJS Am 2006: 964-73 Gartsmann JBJS Am 2000 Bradley Edwards JSES 2003 Bryant JBJS Am 2005 Sandow JSES 2013
- 29. Steve Copeland Fellows Teaching 26/9/14
- 30. Copeland Surface Replacement Fellows Teaching 26/9/14 Copeland JBJS Br 2001: 213-21
- 31. Pyro-carbon Replacement Fellows Teaching 26/9/14
- 32. Extended Head Fellows Teaching 26/9/14
- 33. Partial Surface Replacements Fellows Teaching 26/9/14
- 34. Fellows Teaching 26/9/14 Keeled glenoids Pegged Glenoids Anchor Pegs ? Metal Backed?
- 35. Pegs or Keels? Fellows Teaching 26/9/14 Nuttall JSES 2007 Gartsman JSES 2005: 252-257
- 36. Anchor Pegs Fellows Teaching 26/9/14
- 37. Metal Backed Glenoids Fellows Teaching 26/9/14 Cofield JBJS 2008
- 38. Metal Backed Glenoids Fellows Teaching 26/9/14
- 39. Metal Backed Glenoids Fellows Teaching 26/9/14 Boileau JSES 2002: 351-9
- 40. Fellows Teaching 26/9/14 Stemmed implants – cemented /uncemented Short Stems Metaphyseal Bearing
- 41. Stumpy Stems Fellows Teaching 26/9/14
- 42. Metaphyseal Bearing Fellows Teaching 26/9/14
- 43. Current State with TSR • Anatomic • Cemented or press-fit • All poly or poly/metal glenoids • Revision options Fellows Teaching 26/9/14
- 44. Metal Backed Glenoids Fellows Teaching 26/9/14 Castagna JBJS Br 2010: 1410-5
- 46. Current State with Reverse • Less instability • Less notching • Revision options Fellows Teaching 26/9/14
- 50. Lateralising the Joint - Bony Fellows Teaching 26/9/14
- 51. Lateralising the joint – with bone Fellows Teaching 26/9/14
- 52. Lateralising the Joint – with prosthesis Fellows Teaching 26/9/14
- 54. Cuff Failure Fellows Teaching 26/9/14
- 55. Going Forward • Trabecular Metal • Longer Pegs • Glenoid Preparation • Glenoid Augmentation • Grafting options • Planning Fellows Teaching 26/9/14
- 56. Trabecular Metal Fellows Teaching 26/9/14
- 57. Trabecular Metal Fellows Teaching 26/9/14
- 58. Glenoid Augmentation Fellows Teaching 26/9/14
- 59. 3D Planning Fellows Teaching 26/9/14