McClelland, D, Ogrodnik, P, Blackwell, R and Grocott, N (2021) Determining the ideal osteotomy for stemless total shoulder replacement – a cadaveric study. Journal of Shoulder and Elbow Surgery, 31 (2). pp. 413-419. ISSN 1058-2746

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Hypothesis: To determine the angle of osteotomy that produces a circular humeral cut surface.
Methods: 49 cadaveric shoulders, from 25 cadavers, underwent sequential humeral head osteotomy from 180 degrees (vertical, in line with the humeral diaphyseal shaft) in 10-degree increments, until the rotator cuff insertion was encountered. At each stage the antero10 posterior and the supero-inferior distances were recorded. The data was analyzed for normality and then assessed to determine the optimum cut angle.
Results: The AP/SI ratio is an indication of roundness. Plotting values of 1-AP/SI (i.e. error) versus cut angle allows us to plot the likelihood of producing a circular cut surface using a third order curve which created the best fit to the data set (R2 = 0.99). The results from this study suggest that the optimum osteotomy angle that produces a circular cut surface is 23 degrees from the vertical. The cohort data illustrates that at this angle the average roundness error is 1% with a 95% confidence limit of less than 1%. There is no significant difference (p>0.05) between genders.
Conclusion: The humeral head shape changes from an oval to circular, and then to an oval cut surface as the osteotomy angle increases from the vertical towards the horizontal. The range of angles within which the cut surface is circular, within 10% error, is degrees from the vertical, which is much less than the traditional osteotomy angle of 45 degrees.

Item Type: Article
Additional Information: This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2021 Published by Elsevier Inc. on behalf of Journal of Shoulder and Elbow Surgery Board of Trustees. Any other information required, even copyrights information, can be found online on the publisher website
Uncontrolled Keywords: Humeral replacement; stemless replacement; humeral osteotomy
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RD Surgery
R Medicine > RD Surgery > RD32 Operative surgery. Technique of surgical operations
Divisions: Faculty of Medicine and Health Sciences > School of Pharmacy and Bioengineering
Related URLs:
Depositing User: Symplectic
Date Deposited: 23 Sep 2021 10:04
Last Modified: 21 Sep 2022 01:30

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