Optimizing reverse shoulder arthroplasty component position in the setting of advanced arthritis with posterior glenoid erosion: a computer-enhanced range of motion analysis

2018 ◽  
Vol 27 (2) ◽  
pp. 339-349 ◽  
Author(s):  
Jay D. Keener ◽  
Brendan M. Patterson ◽  
Nathan Orvets ◽  
Alexander W. Aleem ◽  
Aaron M. Chamberlain
Keyword(s):  
Range Of Motion ◽  
Motion Analysis ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Component Position ◽  
Glenoid Erosion

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.

scholarly journals Effect of humeral stem design on humeral position and range of motion in reverse shoulder arthroplasty

2015 ◽  
Vol 39 (11) ◽  
pp. 2205-2213 ◽  
Author(s):  
Alexandre Lädermann ◽  
Patrick J. Denard ◽  
Pascal Boileau ◽  
Alain Farron ◽  
Pierric Deransart ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Stem Design

scholarly journals Effect of Critical Shoulder Angle, Glenoid Lateralization and Humeral Inclination on Range of Motion in Reverse Shoulder Arthroplasty

2019 ◽  
Vol 3 (4) ◽  
pp. 240
Author(s):  
Alexandre Lädermann ◽  
Eileen Tay ◽  
Philippe Collin ◽  
Joe Chih-Hao Chiu ◽  
Caecilia Charbonnier
Keyword(s):  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Critical Shoulder Angle ◽  
Shoulder Angle

scholarly journals The effect of humeral polyethylene insert constraint on reverse shoulder arthroplasty biomechanics

2017 ◽  
Vol 10 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Irfan Abdulla ◽  
Daniel G Langohr ◽  
Joshua W. Giles ◽  
James A. Johnson ◽  
George S. Athwal
Keyword(s):  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Biomechanical Study ◽  
Polyethylene Insert ◽  
Muscle Forces ◽  
Joint Load ◽  
Joint Loads ◽  
Load Angle ◽  
Active Abduction

Background There is little information on the effects of altering reverse shoulder arthroplasty (RSA) polyethylene constraint on joint load, load angle and deltoid force. The present biomechanical study aimed to investigate the effects of changing RSA polyethylene constraint on joint load, load angle, deltoid force and range of motion. Methods A custom RSA implant capable of measuring forces across the joint with varying polyethylene constraint was tested in six cadaveric shoulders. Standard-, low- and high-constraint (retentive) polyethylene liners were tested, and joint kinematics, loads and muscle forces were recorded. Results When polyethylene constraint was altered, joint load and load angle during active abduction were not affected significantly ( p > 0.19). Additionally, the force required by the deltoid for active abduction was not affected significantly by cup constraint ( p = 0.144). Interestingly, active abduction range of motion was also not affected significantly by changes in cup constraint ( p > 0.45). Conclusions Altering polyethylene cup constraint in RSA to enhance stability does not significantly alter resultant joint loads and deltoid forces. Surprisingly, terminal abduction range of motion was also not significantly different with varying cup constraint, indicating that terminal impingement may be tuberosity related rather than polyethylene.

Prediction of Impingement-Free Range of Motion Prior to Reverse Shoulder Arthroplasty

2020 ◽  
Vol 29 (4) ◽  
pp. e170
Author(s):  
Vani J. Sabesan ◽  
Jordan Grauer ◽  
Bhavya Sheth ◽  
Matthew Stankard ◽  
Diego J.L. Lima ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Free Range

scholarly journals Anatomical and reverse shoulder arthroplasty utilizing a single implant system with a platform stem: A prospective observational study with midterm follow-up

2019 ◽  
Vol 12 (5) ◽  
pp. 330-337
Author(s):  
Lindsay Flynn ◽  
Matthew R Patrick ◽  
Christopher Roche ◽  
Joseph D Zuckerman ◽  
Pierre-Henri Flurin ◽  
...  
Keyword(s):  
Los Angeles ◽  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Outcome Scores ◽  
Implant System ◽  
Reverse Total Shoulder

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.

Postoperative stiffness after reverse total shoulder arthroplasty

2020 ◽  
pp. 175857322096731
Author(s):  
Mohammad Ghoraishian ◽  
Brian W Hill ◽  
Thema Nicholson ◽  
Matthew L Ramsey ◽  
Gerald R Williams ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Patient Reported Outcome ◽  
Implant Design ◽  
Consecutive Series ◽  
Patient Reported ◽  
Outcome Scores ◽  
One Year

Purpose The purpose of this study was to evaluate the rate and risk factors for stiffness after reverse shoulder arthroplasty and the ramifications on the patient-reported outcomes. Method A consecutive series of patients who underwent reverse shoulder arthroplasty were prospectively followed for one year. Passive range of motion was measured preoperatively and at regular intervals postoperatively. Patients with passive forward elevation of less than 100° or passive external rotation of less than 30° were defined as stiff. Radiographic parameters and postoperative patient-reported outcome scores were collected. Results Seventy-six patients were available for review. The prevalence of postoperative stiffness following reverse shoulder arthroplasty was 47% at three months, 31% at six months, and 25% at one year. Preoperative shoulder stiffness was associated with three-month postoperative stiffness only. In patients with one-year stiffness, smaller ( p = 0.03) and less lateralized glenospheres ( p = 0.024) were more common. Stiffness was not associated with one-year patient-reported outcome scores. Conclusion Stiffness is common after reverse shoulder arthroplasty and often improves at one-year after surgery. Implant design and selection may be important determinants of passive range of motion. While stiffness does not appear to influence patient-reported outcome scores, one of four patients will potentially have stiffness one year following reverse shoulder arthroplasty. Level of evidence: Level III; retrospective study.

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