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| Format: | Recurso digital |
| Language: | English |
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2026
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| Online Access: | https://doi.org/10.5281/zenodo.18531102 |
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| _version_ | 1866901623777787904 |
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| author | Chi-Ming, Chiang |
| author_facet | Chi-Ming, Chiang |
| contents | <p><strong><span>Abstract</span></strong></p> <p>Patients with chronic kidney disease–mineral and bone disorder (CKD-MBD) present a biomechanical paradox: a high-demand joint environment coupled with a metabolically compromised skeletal substrate. In this high-entropy host bed, rigid glenoid implants can create a pronounced impedance mismatch (stiffness cliff) at the implant-bone interface, amplifying interfacial stresses and predisposing to early loosening. We report a hemodialysis patient with end-stage renal osteodystrophy and advanced glenohumeral arthropathy with substantial glenoid bone loss. During hemi-shoulder arthroplasty, the resected humeral head was contoured as a structural autograft to resurface the glenoid and restore containment. This in-situ reconstruction repurposed the resected bone as a biological impedance matcher, avoiding the introduction of a rigid metal-bone interface. At final follow-up, active forward flexion 110°, abduction 90°, external rotation 25°, and internal rotation to L5 were achieved with pain relief, and radiographs showed maintained graft position without lucency. Autologous humeral-head glenoid resurfacing reframes glenoid reconstruction as a physics-informed biological coupling strategy designed to smooth stress transmission across a metabolically fragile interface.</p> |
| format | Recurso digital |
| id | zenodo_https___doi_org_10_5281_zenodo_18531102 |
| institution | Zenodo |
| language | eng |
| publishDate | 2026 |
| publisher | Zenodo |
| record_format | zenodo |
| spellingShingle | Bypassing the Stiffness Cliff: Biological Impedance Matching for Shoulder Arthroplasty in the Metaboli cally Compromised Host Chi-Ming, Chiang Renal osteodystrophy; CKD-MBD; biological impedance matching; glenoid resurfacing; structural autograft; hemiarthroplasty <p><strong><span>Abstract</span></strong></p> <p>Patients with chronic kidney disease–mineral and bone disorder (CKD-MBD) present a biomechanical paradox: a high-demand joint environment coupled with a metabolically compromised skeletal substrate. In this high-entropy host bed, rigid glenoid implants can create a pronounced impedance mismatch (stiffness cliff) at the implant-bone interface, amplifying interfacial stresses and predisposing to early loosening. We report a hemodialysis patient with end-stage renal osteodystrophy and advanced glenohumeral arthropathy with substantial glenoid bone loss. During hemi-shoulder arthroplasty, the resected humeral head was contoured as a structural autograft to resurface the glenoid and restore containment. This in-situ reconstruction repurposed the resected bone as a biological impedance matcher, avoiding the introduction of a rigid metal-bone interface. At final follow-up, active forward flexion 110°, abduction 90°, external rotation 25°, and internal rotation to L5 were achieved with pain relief, and radiographs showed maintained graft position without lucency. Autologous humeral-head glenoid resurfacing reframes glenoid reconstruction as a physics-informed biological coupling strategy designed to smooth stress transmission across a metabolically fragile interface.</p> |
| title | Bypassing the Stiffness Cliff: Biological Impedance Matching for Shoulder Arthroplasty in the Metaboli cally Compromised Host |
| topic | Renal osteodystrophy; CKD-MBD; biological impedance matching; glenoid resurfacing; structural autograft; hemiarthroplasty |
| url | https://doi.org/10.5281/zenodo.18531102 |