We used a cadaveric model to examine the mechanical effects of changes
in the conformity of the articular surfaces and the size of the humeral
head component in glenohumeral arthroplasty. The experimental system
permitted a manual clinical examination of the glenohumeral joint while
sensors monitored the humeroscapular position and orientation as well as
the forces and torques applied by the examiner. Four preparations were
compared: an anatomical humeroscapular preparation and three glenohumeral
arthroplasty preparations (one with anatomically sized components and a
radius of curvature of the glenoid that was four millimeters larger than
that of the humeral head, one with anatomically sized components and a
radius of curvature of the glenoid that was equal to that of the humeral
head, and one with a non-anatomical, large humeral head component and a
radius of curvature of the glenoid that was equal to that of the humeral
head). All motions, including flexion, external and internal rotation, and
maximum elevation, were diminished with use of the non-anatomical, large
humeral head component. Laxity of the joint on drawer and sulcus tests was
not affected by the conformity of the articular surfaces but was decreased
significantly by implantation of the large humeral head component. The
kinematics of the glenohumeral joint were not markedly altered by reduction
of the uniformity between the articular surfaces of the prosthetic
components. In all preparations, obligate displacement of the humeral head
associated with a passive range of motion occurred at smaller angles with
the large humeral head component.