scholarly journals Range of motion after reverse shoulder arthroplasty: which combinations of humeral stem and glenosphere work best?

2020 ◽  
Vol 15 (3) ◽  
pp. 172-178
Author(s):  
Alexandre Lädermann ◽  
Philippe Collin ◽  
Patrick J. Denard
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Dramatic Improvement ◽  
Prosthetic Design ◽  
Neck Shaft Angle ◽  
Forward Flexion ◽  
Shaft Angle ◽  
Case Basis

Abstract A variety of changes in prosthetic design have been proposed to address the complications of Grammont-style reverse shoulder arthroplasty (RSA). The Grammont RSA is excellent at restoring forward flexion, but often leads to little improvement in external and internal rotation. The purpose of this review was to analyze the effect of different glenoid and humeral configurations on range of motion (ROM) following RSA. With low neck-shaft angle (135–145 degrees), glenosphere lateralization, and eccentricity, elevation remains unchanged, abduction slightly decreases, but a dramatic improvement in adduction, extension, and rotations with the elbow at the side are observed. However, all prosthetic designs should be considered on a case-by-case basis to optimize outcome.

The effect of neck-shaft angle, glenosphere size, and cup depth on contact mechanics in reverse shoulder arthroplasty

2016 ◽  
Vol 25 (10) ◽  
pp. e320-e322
Author(s):  
G. Daniel G. Langohr ◽  
Ryan Willing ◽  
John B. Medley ◽  
James A. Johnson ◽  
George S. Athwal
Keyword(s):  
Contact Mechanics ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Neck Shaft Angle ◽  
Shaft Angle

scholarly journals Neck Shaft Angle After Reverse Shoulder Arthroplasty

2019 ◽  
Vol 3 (4) ◽  
pp. 240
Author(s):  
Alexandre Lädermann ◽  
Grégory James Cunningham ◽  
Philippe Collin
Keyword(s):  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Neck Shaft Angle ◽  
Shaft Angle

Radiographic parameters associated with excellent versus poor range of motion outcomes following reverse shoulder arthroplasty

2020 ◽  
pp. 175857322093623
Author(s):  
Georges Haidamous ◽  
Alexandre Lädermann ◽  
Robert U Hartzler ◽  
Bradford O Parsons ◽  
Evan S Lederman ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
External Rotation ◽  
Reverse Shoulder Arthroplasty ◽  
Level Of Evidence ◽  
Component Size ◽  
Excellent Outcome ◽  
Forward Flexion ◽  
Humeral Component ◽  
Radiographic Measurements

Background The purpose was to evaluate the relationship of component size and position to postoperative range of motion following reverse shoulder arthroplasty. The hypothesis was that increased lateralization, larger glenospheres, and a decreased acromiohumeral distance would be associated with excellent postoperative range of motion. Methods A retrospective multicenter study was performed at a minimum of one year postoperatively on 160 patients who underwent primary reverse shoulder arthroplasty with a 135° humeral component. Outcomes were stratified based on postoperative forward flexion and external rotation into excellent ( n = 42), defined as forward flexion >140° and external rotation > 30°, or poor ( n = 36), defined as forward flexion <100° and external rotation < 15°. Radiographic measurements and component features were compared between the two groups. Results A larger glenosphere size was associated with an excellent outcome ( p = 0.009). A 2-mm posterior offset humeral cup ( p = 0.012) and an increased inferior glenosphere overhang (3.1 mm vs 1.4 mm; p = 0.002) were also associated with excellent outcomes. Humeral lateralization and distalization were not associated with an excellent outcome. Conclusion: Larger glenosphere size and inferior positioning as well as posterior humeral offset are associated with improved postoperative range of motion following reverse shoulder arthroplasty. Level of Evidence Level 3, retrospective comparative study.

scholarly journals Can Lateralization of Reverse Shoulder Arthroplasty Improve Active External Rotation in Patients with Preoperative Fatty Infiltration of the Infraspinatus and Teres Minor?

2021 ◽  
Vol 10 (18) ◽  
pp. 4130
Author(s):  
Marko Nabergoj ◽  
Shinzo Onishi ◽  
Alexandre Lädermann ◽  
Houssam Kalache ◽  
Rihard Trebše ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
External Rotation ◽  
Constant Score ◽  
Reverse Shoulder Arthroplasty ◽  
Fatty Infiltration ◽  
Postoperative Recovery ◽  
Neck Shaft Angle ◽  
Shaft Angle ◽  
Teres Minor

(1) Background: Postoperative recovery of external rotation after reverse shoulder arthroplasty (RSA) has been reported despite nonfunctional external rotator muscles. Thus, this study aimed to clinically determine the ideal prosthetic design allowing external rotation recovery in such a cohort. (2) Methods: A monocentric comparative study was retrospectively performed on patients who had primary RSA between June 2013 and February 2018 with a significant preoperative fatty infiltration of the infraspinatus and teres minor. Two groups were formed with patients with a lateral humerus/lateral glenoid 145° onlay RSA—the onlay group (OG), and a medial humerus/lateral glenoid 155° inlay RSA—the inlay group (IG). Patients were matched 1:1 by age, gender, indication, preoperative range of motion (ROM), and Constant score. The ROM and Constant scores were assessed preoperatively and at a minimum follow-up of two years. (3) Results: Forty-seven patients have been included (23 in OG and 24 in IG). Postoperative external rotation increased significantly in the OG only (p = 0.049), and its postoperative value was significantly greater than that of the IG by 11.1° (p = 0.028). (4) Conclusion: The use of a lateralized humeral stem with a low neck-shaft angle resulted in significantly improved external rotation compared to a medialized humeral 155° stem, even in cases of severe fatty infiltration of the infraspinatus and teres minor. Humeral lateralization and a low neck-shaft angle should be favored when planning an RSA in a patient without a functional posterior rotator cuff.

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