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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

The optimal patient-specific placement of the reverse total shoulder component

Delport, Sven 03 1900 (has links)
Thesis (MSc)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Reverse total shoulder arthroplasty is used as the treatment for arthritic rotator cuff deficient shoulders. Some of the most common complications of a reverse shoulder arthroplasty are scapular notching, glenoid dissociations, glenohumeral dislocation, loosening or dissociation of the humeral component and nerve injury. Clinical outcomes are dependent on the preoperative diagnosis, the function of the deltoid and remaining rotator cuff muscles, biomechanical design of the prosthesis, and the orientation and placement of the reverse shoulder component. This study aims to optimize the patient-specific placement of a reverse shoulder component. A simulation software package was developed that can be used to determine the optimal placement of the reverse shoulder prosthesis for a specific patient. This is achieved by maximizing the humerothoracic range of motion and minimizing the adduction deficit. The motion of the simulation model is driven by shoulder complex motion equations adjusted for each patient. This data was obtained from literature with the motion of the arm fixed to the coronal, scapular and sagittal elevation planes. The influence of the various components of the Tornier Aequalis® - Reversed II system, together with changing the glenoid component inclination and humeral component retroversion, was investigated. This allowed the simulation software to be verified and validated, as well as applying the insight and knowledge gained to a case study. Further simulations evaluated a design change of the humeral component neck-shaft angle from the standard 155 ° to 145 ° or 165 °. The reverse shoulder simulation software provides accurate patient-specific Three Dimensional (3D) pre-operative planning and shoulder complex motion simulation. / AFRIKAANSE OPSOMMING: Omgekeerde volledige skouerartoplastie word as behandeling van ontsteking in gewrigsomhulsel-aangetaste skouers gebruik. Onder die algemeenste komplikasies van 'n omgekeerde skouergewrig-operasie is kepe in die skouerblad (skapulier), lostrekkings of onthegting van die gewrigskom (glenoïede), ontwrigting van die boarm/skouergewrig, die loskom of onthegting van die boarmbeen en beskadiging van senuwees. Mediese resultate is afhanklik van diagnose voor die operasie, die werking van die driehoekspier (deltoïede) en oorblywende draaispiere, die biomeganiese ontwerp van die prostese en die oriëntasie en plasing van die omgekeerde skouerkomponent. Hierdie studie is gemik op die beste pasiënt-spesifieke plasing van die omgekeerde skouerkomponent. Die simulasie-sagtewarepakket wat ontwikkel is, kan gebruik word om die optimale plasing van die omgekeerde skouerprostese in die geval van 'n spesifieke pasiënt te bepaal. Dit word gedoen deur die bewegingsvermoë van die bo-armbeen te maksimaliseer en die gebrekkige werking van die trekspiere te minimaliseer. Die werking van die simulasiemodel word gedryf deur die beweging van skouerkomponente te vergelyk, aangepas vir elke pasiënt. Hierdie data is verkry uit literatuur en die koppeling van die arm se beweging aan die belangrikste, skouerblad- en sagittale elevasievlakke. Die invloed van die onderskeie komponente van die Tornier Aequalis® - Reversed II-stelsel is saam met die verandering van die gewrigskom-komponent se helling en bo-armkomponent se terugstoting ondersoek. Sodoende kon die simulasie-sagteware nagegaan, bevestig en geldig verklaar word; en die insig en kennis wat verkry is op 'n gevallestudie toegepas word. Met verdere simulasies is 'n ontwerpwysiging ge- ëvalueer waar die skouerkomponent se beenpyphoek vanaf die standaard van 155° na 145° of 165° verander is. Die omgekeerde skouersimulasiesagteware maak akkurate pasiëntspesifieke driedimensionele (3D) beplanning voor 'n operasie en simulasie van die bewegings skouerdele moontlik.

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