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.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/97141 |
| Date | 03 1900 |
| Creators | Delport, Sven |
| Contributors | Scheffer, C., Stellenbosch University. Faculty of Engineering. Dept. of Mechanical and Mechatronic Engineering. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | Unknown |
| Type | Thesis |
| Format | 108 pages : illustrations |
| Rights | Stellenbosch University |
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