Arenas-Miquelez, Antonio; Murphy, Richard J; Rosa, Andrea; Caironi, Davide; Zumstein, Matthias A. (2021). Impact of humeral and glenoid component variations on range of motion in reverse geometry total shoulder arthroplasty: a standardized computer model study. Journal of shoulder and elbow surgery, 30(4), pp. 763-771. Elsevier 10.1016/j.jse.2020.07.026
![[img]](https://boris.unibe.ch/style/images/fileicons/text.png) |
Text
1-s2.0-S1058274620306212-main.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (1MB) | Request a copy |
BACKGROUND
Multiple modifications of reverse total shoulder arthroplasty (RTSA) since the first Grammont design have developed to improve range of motion (ROM) and avoid notching. The effect of these changes in shoulder kinematics and the best compromise for ROM is still under debate. This computer simulation study evaluates the influence of humeral design, humeral neck-shaft angle (NSA), glenoid lateralization, and glenoid eccentricity on ROM of RTSA.
METHODS
We created a 3-dimensional computer model from computed tomography scans of 13 patients with primary osteoarthritis simulating implantation of a standardized reverse shoulder arthroplasty. We analyzed the effect of 4 different variables on impingement-free ROM: humeral design (inlay vs. semi-inlay vs. onlay), humeral NSA (135° vs. 145° vs. 155°), glenoid lateralization, and glenoid eccentricity on ROM.
RESULTS
The use of different humeral stem designs did not have a significant effect on total global ROM. Reducing NSA demonstrated a significant increase in adduction, and external and internal rotation in adduction, whereas a decrease in abduction and external rotation in abduction. Glenosphere lateralization was the most effective method for increasing total global ROM (P < .0001); however, extreme lateralization (+12 mm) did not show significant benefit compared with moderate lateralization (+4 mm). Glenosphere eccentricity increased only adduction and internal rotation in adduction.
CONCLUSION
Only glenoid lateralization has a significant effect on increasing total global ROM in RTSA. The use of the semi-inlay 145° model combined with 4 mm lateralization and 2 mm inferior eccentricity represents the middle ground and the most universal approach in RTSA.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery |
UniBE Contributor: |
Zumstein, Matthias |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1058-2746 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Kathrin Aeschlimann |
Date Deposited: |
28 Dec 2020 18:16 |
Last Modified: |
05 Dec 2022 15:42 |
Publisher DOI: |
10.1016/j.jse.2020.07.026 |
PubMed ID: |
32763384 |
Uncontrolled Keywords: |
Reverse total shoulder arthroplasty glenosphere lateralization and eccentricity impingement inlay and semi-inlay design neck-shaft angle onlay range of motion |
BORIS DOI: |
10.48350/149047 |
URI: |
https://boris.unibe.ch/id/eprint/149047 |
Actions (login required)
 |
Edit item |