scholarly journals Anterior deltoid muscle tension quantified with shear wave ultrasound elastography correlates with pain level after reverse shoulder arthroplasty

2021 ◽  
Author(s):  
Jonas Schmalzl ◽  
Annabel Fenwick ◽  
Thomas Reichel ◽  
Benedikt Schmitz ◽  
Martin Jordan ◽  
...  
Keyword(s):  
Shear Wave ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Muscle Tension ◽  
Deltoid Muscle ◽  
Ultrasound Elastography ◽  
Pain Level ◽  
Tissue Elasticity ◽  
Wide Range ◽  
Anterior Deltoid

Abstract Introduction Reverse shoulder arthroplasty (RSA) leads to medialization and distalization of the centre of rotation of the shoulder joint resulting in lengthening of the deltoid muscle. Shear wave ultrasound elastography (SWE) is a reliable method for quantifying tissue stiffness. The purpose of this study was to analyse if deltoid muscle tension after RSA correlates with the patients’ pain level. We hypothesized that higher deltoid muscle tension would be associated with increased pain. Material and methods Eighteen patients treated with RSA were included. Constant score (CS) and pain level on the visual analogue scale (VAS) were analysed and SWE was performed on both shoulders. All three regions of the deltoid muscle were examined in resting position and under standardized isometric loading. Results Average patient age was 76 (range 64–84) years and average follow-up was 15 months (range 4–48). The average CS was 66 points (range 35–89) and the average pain level on the VAS was 1.8 (range 0.5–4.7). SWE revealed statistically significant higher muscle tension in the anterior and middle deltoid muscle region in patients after RSA compared to the contralateral non-operated side. There was a statistically significant correlation between pain level and anterior deltoid muscle tension. Conclusion SWE revealed increased tension in the anterior and middle portion of the deltoid muscle after RSA in a clinical setting. Increased tension of the anterior deltoid muscle portion significantly correlated with an increased pain level. SWE is a powerful, cost-effective, quick, dynamic, non-invasive, and radiation-free imaging technique to evaluate tissue elasticity in the shoulder with a wide range of applications. Level of evidence Diagnostic study, Level III.

scholarly journals Changes of Deltoid Tissue Properties after Reserve Shoulder Arthroplasty – A Shear Wave Elastography Study

2020 ◽  
Author(s):  
Anabell Fenwick ◽  
Thomas Reichel ◽  
Lars Eden ◽  
Jonas Schmalzl ◽  
Rainer H Meffert ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Shear Wave ◽  
Shoulder Arthroplasty ◽  
Shear Wave Elastography ◽  
Deltoid Muscle ◽  
Ultrasound Elastography ◽  
Acoustic Radiation Force Impulse ◽  
Future Application ◽  
Diagnostic Study ◽  
Intraoperative Management

Abstract IntroductionThe deltoid muscle plays an essential role for the postoperative functional outcome after reverse shoulder arthroplasty. Ultrasound elastography is areliable method for detecting soft tissueproperties and their changes due to different conditions or pathologies. Tissue stiffness is calculated after application of an acoustic impulse (acoustic radiation force impulse, ARFI), which deforms the underlying tissue. The purpose of this study was to evaluate changes in the deltoid muscle tissue after RSA and reveal a correlation to the functional outcome.Material and methods18 patients treated with reserve shoulder arthroplasty after proximal humeral fracture or cuff arthropathy were included. Shear wave elastography was performed on both sides of three regions of the deltoid muscle. Functional outcome was recorded by VAS, CMS, range of motion and strength (flexibar). Statistical analysis was performed by SPSS.ResultsThe functional outcome was satisfactory (VAS pain: 18 points, VAS function: 64 points, Constant Murley: 66 points). Force was reduced to 48.8N after RTSA in comparison to 58.3 N on the healthy side (p> 0.07). SWE was able to show a higher overall muscle tension of the deltoid in patients after RSA compared to the contralateral non-operated side. The differences were particularly visible in the anterior and middle deltoid region. Under isometric load all deltoid regions showed significantly increased tension, which was particularly eminent in the anterior region of the pars clavicularis.ConclusionShear wave elastography is a reliable method for detecting changes of tension in the deltoid muscle after RTSA and shows a higher tension of all areas of the deltoid, especially prominent in the anterior and middle portion of the deltoid. Future application possibilities are monitoring of deltoid vitality, preoperative assessment and intraoperative management.Level of evidence: diagnostic study, Level III

scholarly journals Quantified Mechanical Properties of the Deltoid Muscle Using the Shear Wave Elastography: Potential Implications for Reverse Shoulder Arthroplasty

PLoS ONE ◽  
2016 ◽  
Vol 11 (5) ◽  
pp. e0155102 ◽  
Author(s):  
Taku Hatta ◽  
Hugo Giambini ◽  
Koji Sukegawa ◽  
Yoshiaki Yamanaka ◽  
John W. Sperling ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Shear Wave ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Shear Wave Elastography ◽  
Deltoid Muscle

Reverse shoulder arthroplasty in patients with pre-operative impairment of the deltoid muscle

2013 ◽  
Vol 95-B (8) ◽  
pp. 1106-1113 ◽  
Author(s):  
A. Lädermann ◽  
G. Walch ◽  
P. J. Denard ◽  
P. Collin ◽  
F. Sirveaux ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Deltoid Muscle

scholarly journals Influence of glenosphere diameter and lateralization on instability of reverse shoulder arthroplasty

2020 ◽  
Vol 15 (3) ◽  
pp. 199-206
Author(s):  
K. Wegmann ◽  
A. Alikhah ◽  
T. Leschinger ◽  
A. Harbrecht ◽  
L. P. Müller ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Statistical Significance ◽  
Reverse Shoulder Arthroplasty ◽  
Deltoid Muscle ◽  
Shoulder Function ◽  
Cuff Tear Arthropathy ◽  
Pulley System ◽  
Test Setup ◽  
Infraspinatus Muscle ◽  
Fresh Frozen

Abstract Background Prosthetic replacement of the proximal humerus with reverse shoulder arthroplasty (RSA) is an established means of treatment. Due to its unique biomechanical characteristics, RSA can restore shoulder function to a satisfying level in the case of cuff tear arthropathy, arthritis, and fractures. However, complications are frequent in RSA, one of the more common being implant instability with dislocation. The present study investigated the influence of glenosphere diameter and metaglene lateralization using a unique test setup. Methods Seven fresh-frozen cadaveric specimens of the shoulder were thawed and dissected. The subscapularis muscle, the infraspinatus, and the three heads of the deltoid muscle were fixed to a pulley system. After implanting an RSA in different configurations (38/42 mm glenosphere with lateralization of +0 mm, +5 mm, or +10 mm), the implants were dislocated using selective muscle pull. The frequency of dislocations depending on the prosthesis configuration was documented. Results The larger glenosphere diameter of 42 mm showed less dislocations than the diameter of 38 mm (39 vs. 46). Lateralization of +0, +5 mm, and +10 mm showed 26, 29, and 30, dislocations, respectively. Dislocation via pull on the infraspinatus muscle was most frequent. None of the results reached statistical significance. Conclusion The current investigation used a novel technique for investigating the effect of lateralization and glenosphere diameter on RSA instability. Despite indicating tendencies, the present test setup could not prove the hypothesis that a larger glenosphere diameter and increased lateralization add to stability. The lack of statistical significance could be attributable to the low specimen number. The clinical significance of lateralization and glenosphere diameter should be further assessed in future biomechanical investigations.

scholarly journals Total Shoulder Arthroplasty

2011 ◽  
Vol 5 (1) ◽  
pp. 106-114 ◽  
Author(s):  
Joaquin Sanchez-Sotelo
Keyword(s):  
Shoulder Arthroplasty ◽  
Soft Tissues ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Inflammatory Arthropathy ◽  
Wide Range ◽  
The Subject ◽  
Humerus Fractures ◽  
And Function

Shoulder arthroplasty has been the subject of marked advances over the last few years. Modern implants provide a wide range of options, including resurfacing of the humeral head, anatomic hemiarthroplasty, total shoulder arthroplasty, reverse shoulder arthroplasty and trauma-specific implants for fractures and nonunions. Most humeral components achieve successful long-term fixation without bone cement. Cemented all-polyethylene glenoid components remain the standard for anatomic total shoulder arthroplasty. The results of shoulder arthroplasty vary depending on the underlying diagnosis, the condition of the soft-tissues, and the type of reconstruction. Total shoulder arthroplasty seems to provide the best outcome for patients with osteoarthritis and inflammatory arthropathy. The outcome of hemiarthroplasty for proximal humerus fractures is somewhat unpredictable, though it seems to have improved with the use of fracture-specific designs, more attention to tuberosity repair, and the selective use of reverse arthroplasty, as well as a shift in indications towards internal fixation. Reverse shoulder arthroplasty has become extremely popular for patients with cuff-tear arthropathy, and its indications have been expanded to the field of revision surgery. Overall, shoulder arthroplasty is a very successful procedure with predictable pain relief and substantial improvements in motion and function.

Quantitative Assessment of Normal Soft-Tissue Elasticity Using Shear-Wave Ultrasound Elastography

2011 ◽  
Vol 197 (3) ◽  
pp. 532-536 ◽  
Author(s):  
Kemal Arda ◽  
Nazan Ciledag ◽  
Elif Aktas ◽  
Bilgin Kadri Arıbas ◽  
Kenan Köse
Keyword(s):  
Soft Tissue ◽  
Shear Wave ◽  
Quantitative Assessment ◽  
Ultrasound Elastography ◽  
Tissue Elasticity

How common are acromial and scapular spine fractures after reverse shoulder arthroplasty?

2019 ◽  
Vol 101-B (6) ◽  
pp. 627-634 ◽  
Author(s):  
J. J. King ◽  
S. S. Dalton ◽  
L. V. Gulotta ◽  
T. W. Wright ◽  
B. S. Schoch
Keyword(s):  
Incidence Rate ◽  
Shoulder Arthroplasty ◽  
Inflammatory Arthritis ◽  
English Literature ◽  
Reverse Shoulder Arthroplasty ◽  
Revision Arthroplasty ◽  
Fracture Rate ◽  
Spine Fractures ◽  
Wide Range ◽  
Scapular Spine

Aims Acromial fractures following reverse shoulder arthroplasty (RSA) have a wide range of incidences in reported case series. This study evaluates their incidence following RSA by systematically reviewing the current literature. Materials and Methods A systematic review using the search terms “reverse shoulder”, “reverse total shoulder”, or “inverted shoulder” was performed using PubMed, Web of Science, and Cochrane databases between 1 January 2010 and 31 March 2018. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Studies were included if they reported on RSA outcomes and the incidence rate of acromial and/or scapular spine fractures. The rate of these fractures was evaluated for primary RSA, revision RSA, RSA indications, and RSA implant design. Results The review included 90 articles out of 686 identified after exclusions. The incidence rate of acromial and/or scapular spine fractures was 2.8% (253/9048 RSAs). The fracture rate was similar for primary and revision RSA (2.8% vs 2.1%; p = 0.4). Acromial fractures were most common after RSA for inflammatory arthritis (10.9%) and massive rotator cuff tears (3.8%). The incidence was lowest in RSA for post-traumatic arthritis (2.1%) and acute proximal humerus fractures (0%). Lateralized glenosphere design had a significantly higher rate of acromial fractures compared with medial glenosphere designs. Conclusion Based on current English literature, acromial and/or scapular spine fractures occur at a rate of 2.8% after RSA. The incidence is slightly more common after primary compared with revision arthroplasty. Also, higher rates of acromial fractures are reported in RSA performed for inflammatory arthritis and in the lateralized glenoid design. Cite this article: Bone Joint J 2019;101-B:627–634.

Sign in / Sign up

Export Citation Format

Share Document