Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement* by MICHAEL...

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Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement* by MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am Volume 81(5):660-71 May 1, 1999 ©1999 by The Journal of Bone and Joint Surgery, Inc.

Transcript of Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement* by MICHAEL...

Page 1: Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement* by MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am Volume.

Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement*

by MICHAEL L. PEARL, and SAM KURUTZ

J Bone Joint Surg AmVolume 81(5):660-71

May 1, 1999

©1999 by The Journal of Bone and Joint Surgery, Inc.

Page 2: Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement* by MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am Volume.

Fig. 1 Schematic representation showing the geometry of the prosthesis.

MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am 1999;81:660-71

©1999 by The Journal of Bone and Joint Surgery, Inc.

Page 3: Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement* by MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am Volume.

Fig. 2 Anteroposterior radiograph of the proximal aspect of a humerus from a cadaveric specimen, showing the center of rotation (black dot), the base of the articular surface (white

broken line), and the center line of the reamed canal (vertical black line).

MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am 1999;81:660-71

©1999 by The Journal of Bone and Joint Surgery, Inc.

Page 4: Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement* by MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am Volume.

Fig. 3 Illustration showing the placement of the osteotomy (broken line) at 45 degrees on specimens with head-shaft angles of 45 degrees (A), 32 degrees (B), and 51 degrees (C).

MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am 1999;81:660-71

©1999 by The Journal of Bone and Joint Surgery, Inc.

Page 5: Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement* by MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am Volume.

Fig. 4 Plot of the articular surfaces for the prosthesis (shaded) and specimen (clear) combination with the least displacement of the articular surface.

MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am 1999;81:660-71

©1999 by The Journal of Bone and Joint Surgery, Inc.

Page 6: Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement* by MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am Volume.

Figs. 5-A and 5-B: Plots of articular surfaces showing the best match of the Bio-Modular and Kirschner II-C prostheses to the same specimen shown in Fig. 4.

MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am 1999;81:660-71

©1999 by The Journal of Bone and Joint Surgery, Inc.

Page 7: Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement* by MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am Volume.

Fig. 5-B The Kirschner II-C prosthesis that was selected had a stem-head angle of 50 degrees and a radius of curvature of 25.4 millimeters.

MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am 1999;81:660-71

©1999 by The Journal of Bone and Joint Surgery, Inc.

Page 8: Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement* by MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am Volume.

Fig. 6 Plot of articular surfaces for the prosthesis (shaded) and specimen (clear) combination with maximum displacement of the center of rotation (CR) (31.4 millimeters).

MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am 1999;81:660-71

©1999 by The Journal of Bone and Joint Surgery, Inc.

Page 9: Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement* by MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am Volume.

Fig. 7 Plot of articular surfaces for the prosthesis (shaded) and specimen (clear) combination with greatest diminution in the arc of the articular surface (41 degrees), from 161 to 120 degrees.

MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am 1999;81:660-71

©1999 by The Journal of Bone and Joint Surgery, Inc.

Page 10: Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement* by MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am Volume.

Figs. 8-A and 8-B: Plots of articular surfaces for the Global shoulder prosthesis and the same specimen as shown in Fig. 7, with use of larger head sizes.

MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am 1999;81:660-71

©1999 by The Journal of Bone and Joint Surgery, Inc.

Page 11: Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement* by MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am Volume.

Fig. 8-B A prosthesis with a large-sized head.

MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am 1999;81:660-71

©1999 by The Journal of Bone and Joint Surgery, Inc.

Page 12: Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement* by MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am Volume.

Figs. 9-A and 9-B: Plots of articular surfaces for the Global shoulder prosthesis and specimen, with use of both algorithms.

MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am 1999;81:660-71

©1999 by The Journal of Bone and Joint Surgery, Inc.

Page 13: Geometric Analysis of Commonly Used Prosthetic Systems for Proximal Humeral Replacement* by MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am Volume.

Fig. 9-B Plot of the Global shoulder prosthesis with a head-shaft angle of 45 degrees.

MICHAEL L. PEARL, and SAM KURUTZ J Bone Joint Surg Am 1999;81:660-71

©1999 by The Journal of Bone and Joint Surgery, Inc.