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Biomechanics of the Normal and Reverse Shoulder

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Reverse Shoulder Arthroplasty

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Abstract

The middle deltoid is the prime mover of the shoulder in abduction with a peak moment arm measuring approximately 3 cm for abduction in the scapular plane. The peak force developed by the deltoid during scapular-plane abduction is around 8 times the weight of the upper limb, while the peak force transmitted across the glenohumeral joint is estimated to be around 13 times the weight of the upper limb [or 0.7 times body weight (BW)]. Functional activities such as lifting a suitcase incur much higher glenohumeral joint reaction forces than unloaded abduction, with peak forces estimated to be in the vicinity of 2 BW. The rotator cuff muscles act to stabilize the glenohumeral joint during abduction, whereas the middle deltoid and pectoralis major create relatively large shear forces that tend to translate the humeral head along the face of the glenoid. Reverse shoulder arthroplasty moves the glenohumeral joint center medially relative to its location in the normal shoulder, thereby increasing the moment arm of the deltoid and decreasing the force developed by the muscle during humeral abduction. As a result, the compressive force acting across the glenohumeral joint and the resultant joint reaction force are both lower in the reverse shoulder compared to the normal shoulder.

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Acknowledgments

I thank Ms. Rajespree Moodley for her help with figure preparation. This work was supported by an Innovation Fellowship awarded to MGP by the Victorian Endowment for Science, Knowledge, and Innovation.

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Authors and Affiliations

  1. Department of Mechanical Engineering, University of Melbourne, 1-100 Grattan Street, Parkville, VIC, 3010, Australia

    Marcus G. Pandy

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  1. Marcus G. Pandy
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Correspondence to Marcus G. Pandy .

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Editors and Affiliations

  1. Florida Orthopedic Institute, Tampa, Florida, USA

    Mark Frankle

  2. Foundation for Orthopedic Research and Education, Tampa, Florida, USA

    Scott Marberry

  3. Foundation for Orthopedic Research and Education, Tampa, Florida, USA

    Derek Pupello

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© 2016 Springer International Publishing Switzerland

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Pandy, M.G. (2016). Biomechanics of the Normal and Reverse Shoulder. In: Frankle, M., Marberry, S., Pupello, D. (eds) Reverse Shoulder Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-319-20840-4_7

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  • DOI: https://doi.org/10.1007/978-3-319-20840-4_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-20839-8

  • Online ISBN: 978-3-319-20840-4

  • eBook Packages: MedicineMedicine (R0)

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