Abstract
Background: The purpose of this study was to quantitatively evaluate the effect of the prosthetic humeral head shape on rotational range of motion and glenohumeral joint kinematics. Methods: Six fresh-frozen cadaveric shoulders were tested in multiple positions under anatomic muscle loading. Specimens were tested for the native head, and then the spherical and non-spherical prosthetic heads were randomly implanted in the same stem to preserve the center of rotation. Rotational range of motion was measured with 3.3 Nm of torque. Glenohumeral joint kinematics was quantified by the position vectors of the humeral head apex (HHA) and geometric center of the humeral head (GCHH) to calculate translation of HHA and GCHH per degree of humeral rotation. Results: The non-spherical prosthetic head replicated the native head shape more accurately than the spherical prosthetic head. Between the non-spherical and native heads, there was no statistical difference in rotational range of motion (P>.05), but a statistical difference in HHA and GCHH translation was found at 60° of scapular plane abduction in the interval from 30° of internal rotation to neutral rotation and at 30° of forward flexion plane abduction in the interval from 30° of external rotation to maximum external rotation, respectively (P<.05). The spherical head significantly decreased rotational range of motion (P<.05), increased HHA translation per degree (P<.05), and decreased GCHH translation per degree (P<.05) in multiple positions compared with the native humeral head. Conclusion: The custom, non-spherical prosthetic head more accurately replicated the head shape, rotational range of motion, and glenohumeral joint kinematics than the commercially available, spherical prosthetic head compared with the native humeral head. © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees.