Reuben Gobezie1, Yousef Shishani2, Evan Lederman3, Patrick J Denard4. 1. The Cleveland Shoulder Institute, Beachwood, OH, USA. Electronic address: yousef@clevelandshoulder.com. 2. The Cleveland Shoulder Institute, Beachwood, OH, USA. 3. The Orthopedic Clinic Association, Phoenix, AZ, USA; Department of Orthopedic Surgery, Banner University Medical Center, Phoenix, AZ, USA. 4. Southern Oregon Orthopedics, Medford, OR and Department of Orthopaedic & Rehabilitation, Oregon Health & Science University, Portland, OR, USA.
Abstract
BACKGROUND: The purpose of this randomized controlled trial was to compare humeral inclinations of 135° and 155° in patients undergoing primary reverse shoulder arthroplasty (RSA). Our hypothesis was that forward flexion would be higher in the 155° group but be associated with a higher rate of scapular notching. METHODS: A randomized controlled trial was conducted on 100 primary RSAs performed with a humeral inclination of either 135° or 155°. The prostheses were otherwise identical and a neutral glenosphere was used in all cases. Functional outcome, forward flexion, external rotation, and scapular notching were assessed at a minimum of 2 years postoperatively. RESULTS: There was no difference in range of motion or functional outcome scores between the 2 groups. In the 155° group, forward flexion improved from 76° to 135° (P < .001) and external rotation remained unchanged (29° vs. 30°; P = .835). In the 135° group, postoperative forward flexion improved from 78° to 132° (P < .001) and external rotation was unchanged (28° vs. 29°; P = .814). Scapular notching was observed in 58% of cases with a 155° inclination compared with 21% with a 135° inclination (P = .009). CONCLUSION: With a neutral glenosphere there was no difference in postoperative forward flexion or external rotation after an RSA with a humeral inclination of 135° compared with 155°. Scapular notching was reduced with the use of 135° design compared with a 155° design but persists at a rate of 21% at 2-year follow-up in the absence of a lateralized glenosphere.
RCT Entities:
BACKGROUND: The purpose of this randomized controlled trial was to compare humeral inclinations of 135° and 155° in patients undergoing primary reverse shoulder arthroplasty (RSA). Our hypothesis was that forward flexion would be higher in the 155° group but be associated with a higher rate of scapular notching. METHODS: A randomized controlled trial was conducted on 100 primary RSAs performed with a humeral inclination of either 135° or 155°. The prostheses were otherwise identical and a neutral glenosphere was used in all cases. Functional outcome, forward flexion, external rotation, and scapular notching were assessed at a minimum of 2 years postoperatively. RESULTS: There was no difference in range of motion or functional outcome scores between the 2 groups. In the 155° group, forward flexion improved from 76° to 135° (P < .001) and external rotation remained unchanged (29° vs. 30°; P = .835). In the 135° group, postoperative forward flexion improved from 78° to 132° (P < .001) and external rotation was unchanged (28° vs. 29°; P = .814). Scapular notching was observed in 58% of cases with a 155° inclination compared with 21% with a 135° inclination (P = .009). CONCLUSION: With a neutral glenosphere there was no difference in postoperative forward flexion or external rotation after an RSA with a humeral inclination of 135° compared with 155°. Scapular notching was reduced with the use of 135° design compared with a 155° design but persists at a rate of 21% at 2-year follow-up in the absence of a lateralized glenosphere.
Authors: Philipp Moroder; Manuel Urvoy; Patric Raiss; Jean-David Werthel; Doruk Akgün; Jean Chaoui; Paul Siegert Journal: Clin Orthop Relat Res Date: 2022-03-01 Impact factor: 4.755
Authors: Sarav S Shah; Alexander M Roche; Spencer W Sullivan; Benjamin T Gaal; Stewart Dalton; Arjun Sharma; Joseph J King; Brian M Grawe; Surena Namdari; Macy Lawler; Joshua Helmkamp; Grant E Garrigues; Thomas W Wright; Bradley S Schoch; Kyle Flik; Randall J Otto; Richard Jones; Andrew Jawa; Peter McCann; Joseph Abboud; Gabe Horneff; Glen Ross; Richard Friedman; Eric T Ricchetti; Douglas Boardman; Robert Z Tashjian; Lawrence V Gulotta Journal: JSES Int Date: 2020-09-10