Influence of humeral stem inclination in reverse shoulder arthroplasty on range of motion: a meta-analysis

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

International Orthopaedics ◽

10.1007/s00264-015-2984-3 ◽

2015 ◽

Vol 39 (11) ◽

pp. 2205-2213 ◽

Cited By ~ 78

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

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

JSES Open Access ◽

10.1016/j.jses.2019.10.032 ◽

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

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Complication rates, dislocation, pain, and postoperative range of motion after reverse shoulder arthroplasty in patients with and without repair of the subscapularis

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2011.04.009 ◽

2012 ◽

Vol 21 (1) ◽

pp. 36-41 ◽

Cited By ~ 105

Author(s):

Jason C. Clark ◽

Joseph Ritchie ◽

Frederick S. Song ◽

Michael J. Kissenberth ◽

Stefan J. Tolan ◽

...

Keyword(s):

Range Of Motion ◽

Shoulder Arthroplasty ◽

Reverse Shoulder Arthroplasty ◽

Complication Rates

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

Shoulder & Elbow ◽

10.1177/1758573217701065 ◽

2017 ◽

Vol 10 (1) ◽

pp. 25-31 ◽

Cited By ~ 2

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.

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3D Kinematic Evaluation of Scapulohumeral Rhythm After Reverse Shoulder Arthroplasty: A Systematic Review and Meta-Analysis

JSES Reviews, Reports, and Techniques ◽

10.1016/j.xrrt.2021.10.009 ◽

2021 ◽

Author(s):

Felipe F. Gonzalez ◽

Raphael S. da Fonseca ◽

Gustavo L. de O. L. Soares ◽

Rafael P. Pitta ◽

Marcos N. Giordano ◽

...

Keyword(s):

Systematic Review ◽

Shoulder Arthroplasty ◽

Meta Analysis ◽

Reverse Shoulder Arthroplasty ◽

Kinematic Evaluation

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Is reverse total shoulder arthroplasty (rTSA) more advantageous than anatomic TSA (aTSA) for osteoarthritis with intact cuff tendon? A systematic review and meta-analysis

Journal of Orthopaedics and Traumatology ◽

10.1186/s10195-022-00625-y ◽

2022 ◽

Vol 23 (1) ◽

Author(s):

Hyojune Kim ◽

Chul-Ho Kim ◽

Minsoo Kim ◽

Wonsun Lee ◽

In-Ho Jeon ◽

...

Keyword(s):

Range Of Motion ◽

Shoulder Arthroplasty ◽

Revision Rate ◽

Meta Analysis ◽

Total Shoulder Arthroplasty ◽

Reverse Total Shoulder Arthroplasty ◽

Functional Scores ◽

Reverse Total Shoulder ◽

Glenoid Loosening

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.

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The effect of subscapularis repair on dislocation rates in reverse shoulder arthroplasty: a meta-analysis and systematic review

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2018.11.069 ◽

2019 ◽

Vol 28 (5) ◽

pp. 989-997 ◽

Cited By ~ 12

Author(s):

Graeme Matthewson ◽

Sahil Kooner ◽

Adam Kwapisz ◽

Jeff Leiter ◽

Jason Old ◽

...

Keyword(s):

Systematic Review ◽

Shoulder Arthroplasty ◽

Meta Analysis ◽

Reverse Shoulder Arthroplasty

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

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2020.01.058 ◽

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

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

Shoulder & Elbow ◽

10.1177/1758573219840675 ◽

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.

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