Shoulder biomechanics of RC repair and Instability: A systematic review of cadaveric methodology |
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| Affiliation: | 1. Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA;2. Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA;3. Department of Orthopaedic Surgery, Yerevan State Medical University, Yerevan, Armenia;4. Department of Mechanical Engineering, Boston University, Boston, MA, USA;1. Syracuse University, Syracuse Biomaterials Institute, Syracuse, NY, United States;2. Department of Bioengineering, Clemson University, Charleston, SC, United States;3. Stryker, Mahwah, NJ, United States;1. Donders Institute for Brain, Cognition and Behaviour P.O. Box 9104, 6500 HE Nijmegen, the Netherlands;2. Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Fürstenweg 185, Austria;1. Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Rome, Italy;2. Engineering, Global Orthopaedics, Sydney, Australia;3. Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.;4. Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.;5. Department of Orthopaedic Surgery, University of Michigan|Michigan Medicine, Ann Arbor, Michigan, U.S.A.;6. Rothman Orthopaedic Institute, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, U.S.A.;7. Department of Orthopaedic Surgery, Yerevan State Medical University, Yerevan, Armenia;1. Dipartimento di Ingegneria, Università degli Studi di Palermo, Palermo, Italy;2. Clinica Ortopedica e Traumatologica del Policlinico ‘Paolo Giaccone’, Università degli Studi di Palermo, Palermo, Italy;3. Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell''Adulto - Università degli Studi di Modena e Reggio Emilia, Italy;4. University of Pisa, Pisa, Italy;1. Muscle Physiology & Mechanics Group, CREHP, DPESS, University of Thessaly, Trikala, Greece;2. Institute for Research and Technology Thessaly-CERTH, Trikala, Greece;3. Human Performance Group, CREHP, DPESS, University of Thessaly, Trikala, Greece;4. Faculty of Sport and Health Sciences, University of St Mark and St John (Marjon), Plymouth, United Kingdom;5. Department of Surgery, Faculty of Medicine, University of Thessaly, Larissa, Greece;6. Department of Nephrology, Faculty of Medicine, University of Thessaly, Larissa, Greece;7. School of Biosciences, University of Kent, United Kingdom;8. School of Sport, Performing Arts and Leisure, Wolverhampton University, United Kingdom;1. Mechanical Engineering Department, College of Engineering, University of Sharjah, PO Box 27272, Sharjah, United Arab Emirates;2. Sustainable Engineering Asset Management Research Group (SEAM), University of Sharjah, PO Box 27272, Sharjah, United Arab Emirates |
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| Abstract: | BackgroundNumerous biomechanical studies have addressed normal shoulder function and the factors that affect it. While these investigations include a mix of in-vivo clinical reports, ex-vivo cadaveric studies, and computer-based simulations, each has its own strengths and limitations. A robust methodology is essential in cadaveric work but does not always come easily. Precise quantitative measurements are difficult in in-vivo studies, and simulation studies require validation steps. This review focuses on ex-vivo cadaveric studies to emphasize the best research methodologies available to simulate physiologically and clinically relevant shoulder motion.MethodsA PubMed and Web of Science search was conducted in March 2017 (and updated in May 2018) to identify the cadaveric studies focused on the shoulder and its function. The key words for this search included rotator cuff (RC) injuries, RC surgery, and their synonyms. The protocol of the study was registered on PROSPERO and is accessible at CRD42017068873.ResultsThirty one studies consisting of 167 specimens with various biomechanical methods met our inclusion criteria. All studies were level V cadaveric studies. Cadaveric biomechanical models are widely used to study shoulder instability and RC repair. These models are commonly limited to the glenohumeral joint by a fixed scapula, passively and discretely move the humerus, and statically load the RC without regard for the integrity of the glenohumeral capsule.ConclusionAll studies captured in this review evaluated shoulder biomechanics. Recent studies in patients suggest that some assumptions made in this space may not fully characterize motion of the human shoulder. With reproducible scapular positioning, dynamic RC activation, and preservation of glenohumeral capsule integrity, cadaveric studies can facilitate proper validation for simulation models and broaden our understanding of the shoulder environment during motion in healthy and disease states. |
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| Keywords: | Cadaveric Shoulder biomechanics RC RC repair Instability Simulation |
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