title: Finite element models of the human shoulder complex: a review of their clinical implications and modelling techniques.
abstract: The human shoulder is a complicated musculoskeletal structure and is a perfect compromise between mobility and stability. The objective of this paper is to provide a thorough review of previous finite element (FE) studies in biomechanics of the human shoulder complex. Those FE studies to investigate shoulder biomechanics have been reviewed according to the physiological and clinical problems addressed: glenohumeral joint stability, rotator cuff tears, joint capsular and labral defects and shoulder arthroplasty. The major findings, limitations, potential clinical applications and modelling techniques of those FE studies are critically discussed. The main challenges faced in order to accurately represent the realistic physiological functions of the shoulder mechanism in FE simulations involve (1) subject-specific representation of the anisotropic nonhomogeneous material properties of the shoulder tissues in both healthy and pathological conditions; (2) definition of boundary and loading conditions based on individualised physiological data; (3) more comprehensive modelling describing the whole shoulder complex including appropriate three-dimensional (3D) representation of all major shoulder hard tissues and soft tissues and their delicate interactions; (4) rigorous in vivo experimental validation of FE simulation results. Fully validated shoulder FE models would greatly enhance our understanding of the aetiology of shoulder disorders, and hence facilitate the development of more efficient clinical diagnoses, non-surgical and surgical treatments, as well as shoulder orthotics and prosthetics. © 2016 The Authors. International Journal for Numerical Methods in Biomedical Engineering published by John Wiley & Sons Ltd.
authors.affiliation: School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, M13 9PL, UK.
authors.forename: Manxu
authors.initials: M
authors.lastname: Zheng
authors.affiliation: School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, M13 9PL, UK.
authors.forename: Zhenmin
authors.initials: Z
authors.lastname: Zou
authors.affiliation: School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, M13 9PL, UK.
authors.forename: Paulo Jorge Da Silva
authors.initials: PJ
authors.lastname: Bartolo
authors.affiliation: School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, M13 9PL, UK.|The University Hospital of South Manchester NHS Foundation Trust, Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Peach
authors.affiliation: School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, M13 9PL, UK.
authors.forename: Lei
authors.initials: L
authors.lastname: Ren
mesh_terms: D001696:Biomechanical Phenomena; D020342:Finite Element Analysis; D006801:Humans; D008953:Models, Anatomic; D012782:Shoulder / Q000033:anatomy & histology* / Q000502:physiology* / Q000503:physiopathology / Q000601:surgery; D012785:Shoulder Joint / Q000033:anatomy & histology* / Q000502:physiology* / Q000503:physiopathology / Q000601:surgery
keywords: arthroplasty; biomechanics; computational modelling; finite element; glenohumeral joint; human shoulder complex