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GENERATION AND SIMULATION OF BIOMECHANICAL MODELS OF BONE-PROSTHESIS SETS IN REVERSE TOTAL SHOULDER ARTHROPLASTY SURGERIES

ABSTRACT:
In last years, biomechanical investigations have led to a better understanding of the biomechanics of the glenohumeral joint, and this development, has allowed the development of a new prosthesis design named reverse shoulder prosthesis in which the hemisphere is placed in the glenoid cavity, favoring the function of the deltoid and helping in this way to reduce some post-surgery complications in patients with damage in their rotor cuff, fractures or degenerative problems. When this implant is placed to replace the shoulder joint, a loss in bone density can occur due to changes in the internal tensions generated by the bone-prosthesis system.
In this context, a new methodology had been created to be able to generate a digital twin from computed tomography (CT) scan to use in a CAD-FEM environment with the mechanical properties of the bones and where a virtual surgery can be made and then simulate the performance of the implant. These models allow the simulation of different scenarios after the virtual surgery is performed. A case study of a patient with four fragment fracture of the humeral head has been developed with the new methodology. 
The results suggest that in certain fragments, the internal stresses vary in a significative way according with the force applied on the sutures.
Keywords: 3D biomechanical models, Finite Element Simulation, Reverse shoulder prosthesis, Biomechanics, Digital Twin