DSC examination of cartilage damage of patients undergoing shoulder replacement

Abstract

Shoulder replacement is a viable surgical treatment for comminuted proximal humerus fractures and shoulder osteoarthritis. Proper evaluation of hyaline cartilage is essential for the right choice of prosthesis; however, there are only a limited number of studies available investigating the cartilage of glenohumeral joint of patients undergoing shoulder replacement. We hypothesized that differential scanning calorimetry (DSC) could determine the grade of cartilage damage in patients undergoing reversed shoulder replacement, providing insights into the structural changes of the human cartilage samples. Sample of hyaline cartilage of glenohumeral joint was harvested during reversed shoulder replacement of orthopaedic and trauma patients. Thermal parameters were measured using DSC, and radiological examination of glenohumeral joint was also done prior to surgery. We have found that changes in thermal characteristics and DSC scans clearly indicate the severity of osteoarthritis and cartilage damage. The denaturation temperature range and the half-width of the heat flow curves were significantly wider in the orthopaedic samples compared to the control and traumatic ones. The calorimetric enthalpy (ΔHcal) exhibited significant differences in both pathologic samples, compared to the control. The melting temperatures (Tm) show that structural change caused by orthopaedic condition is greater than the effect of traumatic. Therefore, differential scanning calorimetry could help to determine the grade of cartilage damage in orthopaedic and trauma patients undergoing reversed shoulder replacement.