PubMed · 16395823
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2005. Artificial disc replacement surgery.. https://pubmed.ncbi.nlm.nih.gov/16395823/
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Sacral insufficiency fractures are an under-diagnosed source of acute lower back pain. A polymethylmethacrylate (PMMA) cement injection procedure called sacroplasty has recently been utilized as a treatment for sacral insufficiency fractures. It is believed that injection of cement reduces fracture micromotion, thus relieving pain. In this study, finite element models were used to examine the mechanical effects of sacroplasty. Finite element models were constructed from CT images of two cadavers on which sacroplasties were performed. The images were used to create the mesh geometry, and to apply non-homogeneous material properties to the models. Models were created representing the case with and without cement, thus simulating the pre- and post-sacroplasty situation. The results indicate that the sacrum has a 3D multi-axial state of strain. While compressive strains were the largest, tensile and shear strains were significant as well. Cement in the sacrum reduced strains 40-60% locally around the cement. However, overall model stiffness only increased 1-4%. This indicates that the effects of sacroplasty are primarily local.
BACKGROUND: The reverse shoulder prosthesis is a prosthesis that has been in clinical use in Europe since 1985 and was approved for use in the United States in 2004. This unique prosthesis has a baseplate attached to the glenoid, which holds a spherical component, while the humeral component includes a polyethylene insert that is flat. This design is the "reverse" configuration of that seen with a conventional arthroplasty, in which the spherical component is part of the humeral component. The indications for the reverse prosthesis are: (1) painful arthritis associated with irreparable rotator cuff tears (cuff tear arthropathy), (2) failed hemiarthroplasty with irreparable rotator cuff tears, (3) pseudoparalysis due to massive, irreparable rotator cuff tears, (4) some reconstructions after tumor resection, and (5) some fractures of the shoulder not repairable or reconstructable with other techniques. This prosthesis can produce a significant reduction in pain and some improvement in function for most of the indications mentioned. However, the unique configuration and the challenge of its insertion can result in a high incidence of a wide variety of unusual complications. Some of these complications, such as dislocation of the components, are similar to conventional shoulder replacement. Other complications, such as notching of the scapula and acromial stress fractures, are unique to this prosthesis. CONCLUSION: The configuration of the reverse prosthesis, its normal radiographic appearance and potential complications associated with its use are reviewed.
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