Influence of Humeral Version and Deltoid Tension on Glenohumeral Kinematics After Reverse Total Shoulder Arthroplasty

2011 ◽  
Author(s):  
Heath B. Henninger ◽  
Alexej Barg ◽  
Robert Z. Tashjian ◽  
Robert T. Burks ◽  
Kent N. Bachus ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Outcome Measures ◽  
Shoulder Arthroplasty ◽  
Surgical Intervention ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
And Function ◽  
Reverse Total Shoulder

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.

Effect of deltoid volume on range of motion and patient-reported outcomes following reverse total shoulder arthroplasty in rotator cuff-intact and rotator cuff-deficient conditions

2020 ◽  
pp. 175857322092504
Author(s):  
Samuel G McClatchy ◽  
Griffin M Heise ◽  
William M Mihalko ◽  
Frederick M Azar ◽  
Richard A Smith ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Patient Reported Outcomes ◽  
Total Shoulder Arthroplasty ◽  
Deltoid Muscle ◽  
Reverse Total Shoulder Arthroplasty ◽  
Shoulder Range Of Motion ◽  
Patient Reported ◽  
Reverse Total Shoulder

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.

scholarly journals Subscapularis in Reverse Total Shoulder Arthroplasty

2019 ◽  
Vol 3 ◽  
pp. 247154921983419 ◽  
Author(s):  
Sebastian F Bigdon ◽  
Lilianna Bolliger ◽  
Christoph E Albers ◽  
Philippe Collin ◽  
Matthias A Zumstein
Keyword(s):  
Range Of Motion ◽  
Current Literature ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
And Function ◽  
Reverse Total Shoulder ◽  
Role And Function

The use of reverse total shoulder arthroplasty (RSA) is becoming increasingly popular, but many biomechanical aspects are poorly understood. Particularly, the role and function of the subscapularis following RSA are unclear. Several clinical and biomechanical studies have analyzed its role in range of motion and stability. There is some evidence that the subscapularis is beneficial for stability but may reduce range of motion. This review provides an overview of the current literature, which suggests that the subscapularis may have a more important role in RSA than originally thought.

Comparison of Methods to Predict Scapular Notching From Radiographs After Reverse Total Shoulder Arthroplasty

2012 ◽  
Author(s):  
Heath B. Henninger ◽  
Michael D. Harris ◽  
Kristen R. Petersen ◽  
Robert T. Burks ◽  
Robert Z. Tashjian
Keyword(s):  
Bone Loss ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
A Priori ◽  
Stress Shielding ◽  
Reverse Total Shoulder Arthroplasty ◽  
Scapular Notching ◽  
Implant Placement ◽  
And Function ◽  
Reverse Total Shoulder

Scapular notching is a complication of reverse total shoulder arthroplasty (rTSA) that results in bone loss on the lateral border of the scapula. Notching has been reported in up to 86% of patients at 5 year follow-up [1], and is graded 1–4 as a function of progressive bone loss [2]. Notching may arise from impingement, erosion, periprosthetic osteolysis, stress shielding or a combination of these [1]. Glenosphere position can mitigate notching by limiting hardware impingement [3–5], but may increase the forces required to abduct the arm [6]. Clinicians might optimize patient range of motion and function via implant placement if susceptibility to notching was known a-priori.

Strain Analysis in the Scapula After a Reverse Total Shoulder Arthroplasty

2012 ◽  
Author(s):  
Radhika J. Patel ◽  
Chi Zhang ◽  
Yingxin Gao
Keyword(s):  
Articular Cartilage ◽  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Cartilage Damage ◽  
Strain Analysis ◽  
Reverse Total Shoulder Arthroplasty ◽  
Articular Cartilage Damage ◽  
Reverse Total Shoulder ◽  
Rotator Cuff Arthropathy

A reverse total shoulder arthroplasty (RTSA) is strongly suggested for patients who suffer from rotator cuff (RTC) arthropathy, where RTC deficiency causes abnormal loading leading to articular cartilage damage. Studies show that 47% of RTSA patients have rotator cuff arthropathy and 27% have some form of osteoarthritis (OA) [1].

Ten years of reverse total shoulder arthroplasty performed for osteoarthritis and intact rotator cuff: indications and outcomes

2017 ◽  
Vol 26 (5) ◽  
pp. e159 ◽  
Author(s):  
Jonathan J. Streit ◽  
Jonathan C. Clark ◽  
Jesse Allert ◽  
Rachel Clark ◽  
Kaitlyn N. Christmas ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder
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