The influence of humeral neck shaft angle and glenoid lateralization on range of motion in reverse shoulder arthroplasty

2017 ◽  
Vol 26 (10) ◽  
pp. 1726-1731 ◽  
Author(s):  
Birgit S. Werner ◽  
Jean Chaoui ◽  
Gilles Walch
Keyword(s):  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Neck Shaft Angle ◽  
Shaft Angle

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

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.

scholarly journals Bony increased-offset reverse shoulder arthroplasty: A meta-analysis of the available evidence

2020 ◽  
pp. 175857322091684
Author(s):  
Richard Dimock ◽  
Mohamed Fathi Elabd ◽  
Mohamed Imam ◽  
Mark Middleton ◽  
Arnaud Godenèche ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
External Rotation ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Reverse Shoulder Arthroplasty ◽  
Case Series ◽  
Autogenous Bone ◽  
Radiographic Outcomes ◽  
Outcome Scores

Background Reverse shoulder arthroplasty (RSA) has revolutionized the management of many shoulder pathologies. Lateralization has become favourable to combat complications (e.g. notching, compromised external rotation), using a metallic, or autogenous bone-graft baseplates – bony increased-offset reverse shoulder arthroplasty (BIO-RSA). We systematically reviewed the literature to determine: Does BIO-RSA improve range of motion and outcome scores? Are notching rates decreased? Does the graft heal? Methods All available prospective studies, trials and case series reporting on BIO-RSA were included. Outcomes were grouped into outcome scores, range of motion and radiographic outcomes. Data were pooled and statistical analysis performed. Results Eight studies reported on 385 RSA – 235 BIO-RSA and 150 standard-RSA (STD-RSA). Follow-up was 20–36 months; average age 74 years. Outcome scores: Constant-Murley and SSV scores showed statistically significant post-operative benefit of BIO-RSA (mean-difference 4.0 (95% confidence interval (CI): 0.79,7.1) and 6.8 (95% CI: 3.8, 9.9)). No Minimal Clinically Importance Difference was surpassed. Range of motion: No difference was found in any direction. Notching: Notching was less likely with BIO-RSA (odds ratio 0.19 (95% CI: 0.10, 0.38)). Healing and loosening: 92% grafts fully healed/incorporated. Loosening rate was 2.4%. Conclusions Literature on BIO-RSA is limited with only one randomised controlled trial (RCT). Weak evidence exists for improved outcome scores. Range of motion is equivocal. Notching rates are significantly lower in BIO-RSA. The graft usually heals.

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