Giovanni Merolla1,2, Ilaria Parel3, Andrea Giovanni Cutti4, Maria Vittoria Filippi5, Paolo Paladini6, Giuseppe Porcellini7. 1. Shoulder and Elbow Unit, D. Cervesi Hospital, Cattolica, AUSL Romagna, Ambito Rimini, Italy. giovannimerolla@hotmail.com. 2. "Marco Simoncelli" Biomechanics Laboratory, D. Cervesi Hospital, Cattolica, AUSL della Romagna, Ambito Rimini, Italy. giovannimerolla@hotmail.com. 3. "Marco Simoncelli" Biomechanics Laboratory, D. Cervesi Hospital, Cattolica, AUSL della Romagna, Ambito Rimini, Italy. 4. INAIL Prostheses Center, Vigorso di Budrio, Italy. 5. Functional Recovery and Rehabilitation Unit, AUSL della Romagna, Ambito Rimini, Italy. 6. Shoulder and Elbow Unit, D. Cervesi Hospital, Cattolica, AUSL Romagna, Ambito Rimini, Italy. 7. Orthopaedic and Trauma Unit, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
Abstract
AIM OF THE STUDY: To evaluate total (TSA) and reverse total shoulder arthroplasty (RTSA) using the Constant-Murley score (CMS) and the scapula-weighted (SW) CMS, an integrated outcome measure that takes into account the compensatory movements of the scapula. METHODS: Twenty-five consecutive patients, 12 with TSA and 13 with RTSA, underwent kinematic analysis before and after shoulder replacement. Measurements included flexion (FLEX) and abduction (ABD) for the humerus and Protraction-Retraction (PR-RE), Medio-Lateral rotation (ME-LA), and Posterior-Anterior tilting (P-A) for the scapula. They were recorded at baseline (T0) and at six (T1) and 12 months (T2). Reference data were obtained from 31 control shoulders. RESULTS: At T1, differences in CMS and SW-CMS were not significant in either group, whereas values at T2 were significantly lower in RTSA patients (p = 0.310 and p = 0.327, respectively). In TSA shoulders, the compensatory scapular movements in FLEX were all reduced from T0 to T2, whereas P-A was increased in ABD. In RTSA patients, the compensatory scapular movements in FLEX showed a general reduction at T1, with an increase in P-A at T2, whereas in ABD, all increased at T1 and decreased at T2 except for P-A, which did not decrease. DISCUSSION: The SW-CMS showed that the physiological scapulothoracic motion was not restored in TSA and RTSA patients; it may be used as a reference for the gradual progression of deltoid and scapular muscle rehabilitation. CONCLUSIONS: The worse CMS and SW-CMS scores found in RTSA patients at six months may be due to the biomechanics of the reverse prosthesis and to the weakness of deltoid and periscapular muscles.
AIM OF THE STUDY: To evaluate total (TSA) and reverse total shoulder arthroplasty (RTSA) using the Constant-Murley score (CMS) and the scapula-weighted (SW) CMS, an integrated outcome measure that takes into account the compensatory movements of the scapula. METHODS: Twenty-five consecutive patients, 12 with TSA and 13 with RTSA, underwent kinematic analysis before and after shoulder replacement. Measurements included flexion (FLEX) and abduction (ABD) for the humerus and Protraction-Retraction (PR-RE), Medio-Lateral rotation (ME-LA), and Posterior-Anterior tilting (P-A) for the scapula. They were recorded at baseline (T0) and at six (T1) and 12 months (T2). Reference data were obtained from 31 control shoulders. RESULTS: At T1, differences in CMS and SW-CMS were not significant in either group, whereas values at T2 were significantly lower in RTSA patients (p = 0.310 and p = 0.327, respectively). In TSA shoulders, the compensatory scapular movements in FLEX were all reduced from T0 to T2, whereas P-A was increased in ABD. In RTSA patients, the compensatory scapular movements in FLEX showed a general reduction at T1, with an increase in P-A at T2, whereas in ABD, all increased at T1 and decreased at T2 except for P-A, which did not decrease. DISCUSSION: The SW-CMS showed that the physiological scapulothoracic motion was not restored in TSA and RTSA patients; it may be used as a reference for the gradual progression of deltoid and scapular muscle rehabilitation. CONCLUSIONS: The worse CMS and SW-CMS scores found in RTSA patients at six months may be due to the biomechanics of the reverse prosthesis and to the weakness of deltoid and periscapular muscles.
Authors: A G Cutti; I Parel; M Raggi; E Petracci; A Pellegrini; A P Accardo; R Sacchetti; G Porcellini Journal: J Biomech Date: 2014-01-13 Impact factor: 2.712
Authors: Giovanni Merolla; Giovanni Ciaramella; Elisabetta Fabbri; Gilles Walch; Paolo Paladini; Giuseppe Porcellini Journal: Int Orthop Date: 2016-08-10 Impact factor: 3.075
Authors: Sebastien Zilber; Eleonora Camana; Peter Lapner; Emil Haritinian; Laurent Nove Josserand Journal: Int Orthop Date: 2018-03-26 Impact factor: 3.075
Authors: Giovanni Merolla; Francesco Cuoghi; George S Athwal; Ilaria Parel; Maria V Filippi; Andrea G Cutti; Elisabetta Fabbri; Antonio Padolino; Paolo Paladini; Fabio Catani; Giuseppe Porcellini Journal: Int Orthop Date: 2021-07-01 Impact factor: 3.075