Alexandra Roren1, Christelle Nguyen2, Clémence Palazzo3, Fouad Fayad4, Michel Revel5, Thomas Gregory6, Serge Poiraudeau7, Agnès Roby-Brami8, Marie-Martine Lefèvre-Colau9. 1. Paris Descartes University, Sorbonne Paris Cité, Paris, France; Department of Physical Medicine and Rehabilitation, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France. 2. Paris Descartes University, Sorbonne Paris Cité, Paris, France; Department of Physical Medicine and Rehabilitation, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM UMR 1124, Laboratoire de Pharmacologie, Toxicologie et Signalisation Cellulaire, UFR des Saints-Pères, Paris, France. Electronic address: christelle.nguyen2@aphp.fr. 3. Paris Descartes University, Sorbonne Paris Cité, Paris, France; Department of Physical Medicine and Rehabilitation, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM UMR 1153, ECaMo Team, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, Paris, France. Electronic address: clemence.palazzo@aphp.fr. 4. Department of Rheumatology, Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon. Electronic address: fouadfayad@yahoo.fr. 5. Paris Descartes University, Sorbonne Paris Cité, Paris, France; Department of Physical Medicine and Rehabilitation, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France. Electronic address: michel.revel@dbmail.com. 6. Paris Descartes University, Sorbonne Paris Cité, Paris, France; Department of Orthopaedic Surgery, European Hospital Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France. Electronic address: thomas.gregory@aphp.fr. 7. Paris Descartes University, Sorbonne Paris Cité, Paris, France; Department of Physical Medicine and Rehabilitation, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM UMR 1153, ECaMo Team, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, Paris, France; Institut Fédératif de Recherche sur le Handicap, INSERM, Paris, France. Electronic address: serge.poiraudeau@aphp.fr. 8. Department of Physical Medicine and Rehabilitation, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Institut des Systèmes Intelligents et de Robotique, Sorbonne University, Pierre et Marie Curie Université, CNRS, UMR 7222, Agathe Team, INSERM, U1150, Paris, France. Electronic address: agnes.roby-brami@isir.upmc.fr. 9. Paris Descartes University, Sorbonne Paris Cité, Paris, France; Department of Physical Medicine and Rehabilitation, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM UMR 1153, ECaMo Team, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, Paris, France. Electronic address: marie-martine.lefevre-colau@aphp.fr.
Abstract
BACKGROUND: The movement of the arm relative to the trunk results from coordinated 3D glenohumeral and scapulothoracic movements. Changes in scapula kinematics may occur after total shoulder arthroplasty and could affect clinical and functional outcomes. OBJECTIVES: To assess the 3D movement of the scapula during arm elevation after anatomic and reverse total shoulder arthroplasty. DESIGN/ METHODS: This was a single-centre, non-randomized, controlled cross-sectional study. Patients with anatomic (n = 14) and reverse total shoulder arthroplasty (n = 9) were prospectively enrolled and were compared to age-matched asymptomatic controls (n = 23). 3D scapular kinematics were assessed by a non-invasive, electromagnetic method during arm abduction and flexion. 3D scapular rotations and 3D linear displacements of the barycentre (geometrical centre) at rest and at 30°, 60° and 90° arm elevation; as well as scapulohumeral rhythm were analysed. Participant groups were compared using one-way ANOVA and Bonferroni post-hoc testing for normally distributed data, and Mann-Whitney U test for non-normally distributed data. RESULTS/ FINDINGS: Total range of scapular lateral rotation and barycentre displacement were increased, and scapulohumeral rhythm was reduced, in patients with anatomic and reverse total shoulder arthroplasty compared with age-matched controls; however, the global scapular kinematic pattern was preserved. CONCLUSION/ INTERPRETATION: For patients after total shoulder arthroplasty, the increased contribution of the scapula to arm elevation is consistent with a compensatory mechanism for the reduced glenohumeral mobility. The stability of the global scapula kinematic pattern reflects its mechanical and neuromotor strength.
BACKGROUND: The movement of the arm relative to the trunk results from coordinated 3D glenohumeral and scapulothoracic movements. Changes in scapula kinematics may occur after total shoulder arthroplasty and could affect clinical and functional outcomes. OBJECTIVES: To assess the 3D movement of the scapula during arm elevation after anatomic and reverse total shoulder arthroplasty. DESIGN/ METHODS: This was a single-centre, non-randomized, controlled cross-sectional study. Patients with anatomic (n = 14) and reverse total shoulder arthroplasty (n = 9) were prospectively enrolled and were compared to age-matched asymptomatic controls (n = 23). 3D scapular kinematics were assessed by a non-invasive, electromagnetic method during arm abduction and flexion. 3D scapular rotations and 3D linear displacements of the barycentre (geometrical centre) at rest and at 30°, 60° and 90° arm elevation; as well as scapulohumeral rhythm were analysed. Participant groups were compared using one-way ANOVA and Bonferroni post-hoc testing for normally distributed data, and Mann-Whitney U test for non-normally distributed data. RESULTS/ FINDINGS: Total range of scapular lateral rotation and barycentre displacement were increased, and scapulohumeral rhythm was reduced, in patients with anatomic and reverse total shoulder arthroplasty compared with age-matched controls; however, the global scapular kinematic pattern was preserved. CONCLUSION/ INTERPRETATION: For patients after total shoulder arthroplasty, the increased contribution of the scapula to arm elevation is consistent with a compensatory mechanism for the reduced glenohumeral mobility. The stability of the global scapula kinematic pattern reflects its mechanical and neuromotor strength.
Authors: Tyler W Knighton; Peter N Chalmers; Hema J Sulkar; Klevis Aliaj; Robert Z Tashjian; Heath B Henninger Journal: J Shoulder Elbow Surg Date: 2022-05-10 Impact factor: 3.507