V J Sabesan1, D Lombardo2, D Josserand3, D Buzas2, T Jelsema2, G R Petersen-Fitts2, J M Wiater4. 1. Department of Orthopaedic Surgery, Wayne State University School of Medicine, 18100 Oakwood Blvd. Suite 305, Dearborn, MI, 48124, USA. sabes001@gmail.com. 2. Department of Orthopaedic Surgery, Wayne State University School of Medicine, 18100 Oakwood Blvd. Suite 305, Dearborn, MI, 48124, USA. 3. Department of Orthopedic Surgery, Botsford Hospital, Michigan State University, Farmington Hills, MI, USA. 4. Department of Orthopaedic Surgery, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA.
Abstract
PURPOSE: Reverse shoulder arthroplasty (RSA) is based on the biomechanical advantages of lengthening the deltoid while medializing its center of rotation (COR). Little evidence exists describing the clinical benefits of these biomechanical advantages. The purpose of this study is to assess the relationship between deltoid lengthening and medialization of the COR with functional outcomes for RSA patients. METHODS: We retrospectively reviewed patients treated with primary RSA. Radiographic measurements of deltoid length and COR, assessment of forward elevation (FE) and external rotation (ER), and functional outcome scores were obtained pre- and postoperatively. Linear regression analyses were performed to assess the relationship between these radiographic measurements and changes in shoulder functionality. RESULTS: On average, patients improved significantly in function and functional outcome scores. Postoperative COR correlated weakly with postoperative FE. There were weakly negative correlations between increase in acromion to greater tuberosity distance and postoperative FE, and between deltoid lengthening and FE improvement. CONCLUSIONS: Our results suggest that deltoid lengthening does not correlate with improvements in active FE or ER. These findings could indicate that change in deltoid length is less important than previously thought. Furthermore, the negative correlations seen could indicate that there is over-tensioning of the deltoid in specific cases. Further studies are needed to better assess the role of deltoid length and other factors that may impact RSA outcomes.
PURPOSE: Reverse shoulder arthroplasty (RSA) is based on the biomechanical advantages of lengthening the deltoid while medializing its center of rotation (COR). Little evidence exists describing the clinical benefits of these biomechanical advantages. The purpose of this study is to assess the relationship between deltoid lengthening and medialization of the COR with functional outcomes for RSApatients. METHODS: We retrospectively reviewed patients treated with primary RSA. Radiographic measurements of deltoid length and COR, assessment of forward elevation (FE) and external rotation (ER), and functional outcome scores were obtained pre- and postoperatively. Linear regression analyses were performed to assess the relationship between these radiographic measurements and changes in shoulder functionality. RESULTS: On average, patients improved significantly in function and functional outcome scores. Postoperative COR correlated weakly with postoperative FE. There were weakly negative correlations between increase in acromion to greater tuberosity distance and postoperative FE, and between deltoid lengthening and FE improvement. CONCLUSIONS: Our results suggest that deltoid lengthening does not correlate with improvements in active FE or ER. These findings could indicate that change in deltoid length is less important than previously thought. Furthermore, the negative correlations seen could indicate that there is over-tensioning of the deltoid in specific cases. Further studies are needed to better assess the role of deltoid length and other factors that may impact RSA outcomes.
Entities:
Keywords:
Center of rotation; Deltoid length; Prosthesis design; Reverse shoulder arthroplasty; Surgical outcomes
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