Association between sagittal spinal alignment and postoperative shoulder range of motion following reverse total shoulder arthroplasty

Author(s):  
Kazumasa Takayama ◽  
Shunsuke Yamada ◽  
Yuu Kobori ◽  
Hayao Shiode
2020 ◽  
pp. 175857322092504
Author(s):  
Samuel G McClatchy ◽  
Griffin M Heise ◽  
William M Mihalko ◽  
Frederick M Azar ◽  
Richard A Smith ◽  
...  

Background Deltoid muscle function is paramount to the success of reverse total shoulder arthroplasty. The purpose of this study was to investigate the role of deltoid volume on shoulder range of motion and patient-reported outcomes following reverse total shoulder arthroplasty in rotator cuff-intact and rotator cuff-deficient conditions. Methods Retrospective review of records identified 107 patients who met inclusion criteria. The rotator cuff integrity was evaluated by two musculoskeletal-trained radiologists. Volumetric deltoid measurements were calculated from preoperative computed tomography or magnetic resonance imaging scans. Satisfactory outcomes were defined as forward elevation of at least 135°, external rotation of at least 35°, and American Shoulder and Elbow Surgeons and Single Assessment Numerical Evaluation scores of at least 70. Results Mean total deltoid muscle volume was significantly higher in patients with satisfactory forward elevation (57.8 ± 18.1 cm³) versus unsatisfactory forward elevation (48.6 ± 19.5 cm³) (p = 0.013). When separated by rotator cuff integrity, total deltoid volume was significantly higher (p = 0.030) in patients who achieved satisfactory forward elevation in the rotator cuff-deficient group but not the rotator cuff-intact group (p = 0.533). Discussion Preoperative deltoid volume directly correlated with achieving satisfactory forward elevation after reverse total shoulder arthroplasty in rotator cuff-deficient conditions and may be one factor in determining the ability to achieve satisfactory outcomes in the rotator cuff-deficient patient.


Author(s):  
Heath B. Henninger ◽  
Alexej Barg ◽  
Robert Z. Tashjian ◽  
Robert T. Burks ◽  
Kent N. Bachus ◽  
...  

Reverse total shoulder arthroplasty (rTSA) is used to improve pain and function in arthritic, rotator cuff deficient shoulders. Surgical intervention is considered successful if range of motion and stability of the joint is maximized and force to abduct the arm is minimized. Implant hardware positioning may affect these outcome measures.


2021 ◽  
Vol 10 (24) ◽  
pp. 5745
Author(s):  
Shivan S. Jassim ◽  
Lukas Ernstbrunner ◽  
Eugene T. Ek

Background: Prosthesis selection, design, and placement in reverse total shoulder arthroplasty (RTSA) affect post-operative results. The aim of this systematic review was to evaluate the influence of the humeral stem version and prosthesis design (inlay vs. onlay) on shoulder function following RTSA. Methods: A systematic review of the literature on post-operative range of motion (ROM) and functional scores following RTSA with specifically known humeral stem implantations was performed using MEDLINE, Pubmed, and Embase databases, and the Cochrane Library. Functional scores included were Constant scores (CSs) and/or American Shoulder and Elbow Surgeons (ASES) scores. The patients were organised into three separate groups based on the implanted version of their humeral stem: (1) less than 20° of retroversion, (2) 20° of retroversion, and (3) greater than 20° of retroversion. Results: Data from 14 studies and a total of 1221 shoulders were eligible for analysis. Patients with a humeral stem implanted at 20° of retroversion had similar post-operative mean ASES (75.8 points) and absolute CS (68.1 points) compared to the group with humeral stems implanted at less than 20° of retroversion (76 points and 62.5 points; p = 0.956 and p = 0.153) and those implanted at more than 20° of retroversion (73.3 points; p = 0.682). Subjects with humeral stem retroversion at greater than 20° tended towards greater active forward elevation and external rotation compared with the group at 20° of retroversion (p = 0.462) and those with less than 20° of retroversion (p = 0.192). Patients with an onlay-type RTSA showed statistically significantly higher mean post-operative internal rotation compared to patients with inlay-type RTSA designs (p = 0.048). Other functional scores and forward elevation results favoured the onlay-types, but greater external rotation was seen in inlay-type RTSA designs (p = 0.382). Conclusions: Humeral stem implantation in RTSA at 20° of retroversion and greater appears to be associated with higher post-operative outcome scores and a greater range of motion when compared with a retroversion of less than 20°. Within these studies, onlay-type RTSA designs were associated with greater forward elevation but less external rotation when compared to inlay-type designs. However, none of the differences in outcome scores and range of motion between the humeral version groups were statistically significant.


2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Hyojune Kim ◽  
Chul-Ho Kim ◽  
Minsoo Kim ◽  
Wonsun Lee ◽  
In-Ho Jeon ◽  
...  

Abstract Purpose We aimed to compare the outcomes and complications of anatomical shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) for primary glenohumeral osteoarthritis with intact cuff tissue. Materials and methods The MEDLINE, Embase, and Cochrane Library databases were systematically searched for studies published before March 2, 2021 using the PRISMA guidelines. Studies were included if they directly compared aTSA and rTSA for treating primary glenohumeral arthritis. A meta-analysis was performed using six studies that compared radiologic outcomes, functional scores, and range of motion (ROM). All the data were pooled using a random-effects model. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated as dichotomous data, while continuous data were analyzed using mean differences with 95% CIs. Results Two independent researchers reviewed 1,061 studies. Six studies met the inclusion criteria. The range of motion, especially external rotation, was better for aTSA than for rTSA (MD = − 10.28, 95% CI: − 16.69 to − 3.88, P = 0.002). Functional scores showed no difference between aTSA and rTSA. Glenoid loosening (OR = 0.17, 95% CI: 0.06–0.50, P = 0.001) was more common with aTSA, and scapula notching (OR = 10.63, 95% CI: 1.73–65.27, P = 0.01) with rTSA. In the mid-term follow-up, the overall revision rate showed no difference between aTSA and rTSA, with a pooled OR of 0.33 (95% CI: 0.07–1.57, P = 0.16). Conclusion A better ROM was achieved after aTSA than after rTSA. There was no difference in the revision rate at mid-term follow-up between aTSA and rTSA. Glenoid loosening was more common with aTSA, and scapula notching with rTSA. Level of evidence: Level IV, Meta-analysis.


2019 ◽  
Vol 12 (5) ◽  
pp. 330-337
Author(s):  
Lindsay Flynn ◽  
Matthew R Patrick ◽  
Christopher Roche ◽  
Joseph D Zuckerman ◽  
Pierre-Henri Flurin ◽  
...  

Background No studies compare outcomes of anatomic total shoulder arthroplasty to reverse total shoulder arthroplasty with more than five-year follow-up. Methods A multicenter prospectively collected shoulder registry was utilized to review all patients undergoing primary anatomic total shoulder arthroplasty or primary reverse total shoulder arthroplasty with a minimum five-year follow-up utilizing a single platform stem implant system. One-hundred-ninety-one patients received an anatomic total shoulder arthroplasty and 139 patients received a reverse total shoulder arthroplasty. Patients were scored preoperatively and at latest follow-up using the simple shoulder test (SST), University of California Los Angeles (UCLA), American shoulder and elbow surgeons (ASES), Constant, and shoulder pain and disability index (SADI) scores as well as range of motion. Radiographs were evaluated for implant loosening or notching. Complications were reviewed. A Student’s two-tailed, unpaired t-test identified differences in preoperative, postoperative, and pre-to-postoperative improvements. Results Reverse total shoulder arthroplasty patients were significantly older than anatomic total shoulder arthroplasty patients. All patients demonstrated significant improvement in functional metric scores and range of motion following anatomic total shoulder arthroplasty or reverse total shoulder arthroplasty. There was no difference in final outcome scores between anatomic total shoulder arthroplasty and reverse total shoulder arthroplasty patients at midterm follow-up; however, reverse total shoulder arthroplasty patients demonstrated significantly less motion. Discussion We demonstrate equivalent outcomes with five scoring metrics at mean follow-up of 71.3 ± 14.1 months. Although postoperative scores were significantly greater than preoperative scores for both anatomic total shoulder arthroplasty and reverse total shoulder arthroplasty patients, significant differences in outcome scores between cohorts were not observed.


Joints ◽  
2015 ◽  
Vol 03 (02) ◽  
pp. 72-77 ◽  
Author(s):  
Lorenzo Mattei ◽  
Stefano Mortera ◽  
Chiara Arrigoni ◽  
Filippo Castoldi

A shoulder replacement is indicated in patients affected by glenohumeral arthropathy with severely reduced range of motion, persistent pain, especially at night, and loss of strength. There is much discussion in the scientific community about the prosthetic options for these cases: hemiarthroplasty, anatomic total shoulder arthroplasty, and reverse total shoulder arthroplasty. We analyzed the indications for, results of, and complications associated with this kind of surgery, focusing on anatomic arthroplasty and on the concept of modularity.


2017 ◽  
Vol 1 ◽  
pp. 247154921770418
Author(s):  
David Y Ding ◽  
Stephanie E Wong ◽  
David Lee ◽  
Nicola Cashman ◽  
Alan L Zhang ◽  
...  

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