Finite element analysis to predict short and medium-term performance of the anatomical Comprehensive® Total Shoulder System

Abstract

BackgroundThe number of Total Shoulder Arthroplasties (TSA) has increased in these last years with significant increase of clinical success. However, glenoid component loosening remains the most common cause of failure. ObjectiveIn this study we evaluated the critical conditions to predict short and medium-term performance of the uncemented anatomical Comprehensive® Total Shoulder System using a finite element model that was validated experimentally. MethodsThe finite element models of an implanted shoulder analysed included total shoulder components with pegs. The models were simulated in 3 phases of adduction: 45°, 60° and 90° to determine the most critical situation. Two different bone-implant fixation conditions were considered: post-surgery and medium term (2 years). ResultsThese show that the critical condition is for the shoulder in 90° adduction were the highest contact stress (70 MPa) was observed in the glenoid component. Relatively to the interface implant-bone strains, the maximum (-16000 µε) was observed for the short-term in the lateral region of the humerus. The highest micromotions were observed in the central fixation post of the glenoid component, ranging from 20 to 25 µm, and 325 µm in the lateral plane of the humeral component. ConclusionThe predicted results are in accordance with clinical studies published and micromotions of the humeral component can be used to predict loosening and to differentiate shoulder implant designs.