Estimating Bone Stiffness in the Proximal Humerus using Single Energy CT and Internal Density Calibration for Stemless Shoulder Arthroplasty

Abstract

Shoulder arthroplasty is a common surgical treatment for individuals with end-stage osteoarthritis (OA) within the glenohumeral joint. New stemless humeral components require only the removal of diseased bone for fixation to the proximal humerus, thereby preserving non-diseased bone for future surgical revisions. However, current pre-operative clinical measures of bone quality fail to account for the mechanical properties of the bone in the region directly supporting the component. The purpose of this study is to determine the predictive value of proximal humerus bone stiffness in patients undergoing shoulder arthroplasty for end-stage OA with patient-specific validated computational models created from retrospective pre-operative single energy computed tomography (CT). Quantitative information from single energy CT images will be used to determine vBMD and FEM estimated stiffness values in the proximal humerus. This is a first step in predicting bone strength through patient specific CT images.