Basic ScienceGlenoid bone resorption after Bankart repair: finite element analysis of postoperative stress distribution of the glenoid
Section snippets
Materials and methods
Five preoperative computed tomographs (CT) from patients with traumatic anterior instability who underwent arthroscopic Bankart repair were used. Preoperative bone defects were less than 10% of the glenoid width in all cases. Amounts of bone loss were measured using the glenoid fossa circle approximation method described by Sugaya et al.25 The subjects included 3 men and 2 women. The mean age at the surgery was 20.2 years (range, 16-26 years).
CT scans were taken with 1.25 mm slice thickness
Results
The stress at 3-4 o’clock was 3.16 MPa in model G and 6.42 MPa in model E (P = .043). The stress at 4-5 o’clock was 1.68 MPa in model G and 4.53 MPa in model E (P = .043). The stress at 5-6 o’clock was 2.26 MPa in model G and 3.93 MPa in model E (P = .043). Model G showed significantly less load stress than model E in all areas.
Since there were only 5 cases, gender and other factors could not be analyzed statistically.
Discussion
The most important finding was significantly lower load stresses at the anteroinferior rim of the glenoid in the model where the cartilage on the glenoid rim was removed between 2 and 7 o’clock and the glenohumeral ligament complex was repaired on the medial edge of the glenoid bone. This finding supports the idea that the decreased lateral diameter of the glenoid width after surgery using the method of removing the articular cartilage was caused by stress shielding.
FEA is widely applied from
Conclusion
Using FEA, load stresses on the anteroinferior area of the glenoid after Bankart repair using a method of removing a 5-mm-thick cartilage on the glenoid rim between 2 and 7 o’clock and repairing the glenohumeral ligament complex on the medial edge of the glenoid bone where the cartilage was removed (model G) and a method of not removing the cartilage of the glenoid rim and repairing the glenohumeral ligament complex on the glenoid edge (model E) were investigated. Significantly lower load
Disclaimer
The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
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New bone formation after arthroscopic Bankart repair for unstable shoulders with an erosion-type glenoid defect
2023, Journal of Shoulder and Elbow SurgeryCitation Excerpt :However, a recent study reported that shoulders with this type of defect show a marked decrease in glenoid width. Hirose et al reported that stress shielding associated with on-the-face anchoring might cause anterior glenoid erosion,6 a hypothesis that was proven by Inoue et al with the finite element method.8 Furthermore, Hirose et al7 reported that on-the-edge anchoring prevented a decrease in glenoid width.
Bankart Repair With Remplissage Restores Better Shoulder Stability Than Bankart Repair Alone, and Medial or Two Remplissage Anchors Increase Stability but Decrease Range of Motion: A Finite Element Analysis
2022, Arthroscopy - Journal of Arthroscopic and Related SurgeryCitation Excerpt :Eventually, the normal glenohumeral joint model was simulated at 60° of abduction. The details of meshing were as follows: (1) Bones and cartilages: the bony structures were meshed with tetrahedral grids whereas 2-dimensional quadrilateral shell elements with a thickness of 1.3 mm were applied for articular cartilage modeling.34-36 (2) Glenoid labrum and joint capsule: a geometric model of the glenoid labrum with the same nodes with the scapula at the junctions was constructed.32,37
The Hokushin Hospital ethics review board approved this study (study no. 1908).