Georges Haidamous1, Alexandre Lädermann2, Robert U Hartzler3, Bradford O Parsons4, Evan S Lederman5, John M Tokish6, Patrick J Denard1,7. 1. Southern Oregon Orthopedics, Medford, OR, USA. 2. Division of Orthopedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland. 3. The San Antonio Orthopedic Group, San Antonio, TX, USA. 4. Mount Sinai Medical Center, New York, NY, USA. 5. University of Arizona College of Medicine Phoenix and the Orthopedic Clinic Association, Phoenix, AZ, USA. 6. Mayo Clinic, Scottsdale, AZ, USA. 7. Department of Orthopaedic & Rehabilitation, Oregon Health & Science University, Portland, OR, USA.
Abstract
BACKGROUND: The purpose was to evaluate the relationship of component size and position to postoperative range of motion following reverse shoulder arthroplasty. The hypothesis was that increased lateralization, larger glenospheres, and a decreased acromiohumeral distance would be associated with excellent postoperative range of motion. METHODS: A retrospective multicenter study was performed at a minimum of one year postoperatively on 160 patients who underwent primary reverse shoulder arthroplasty with a 135° humeral component. Outcomes were stratified based on postoperative forward flexion and external rotation into excellent (n = 42), defined as forward flexion >140° and external rotation > 30°, or poor (n = 36), defined as forward flexion <100° and external rotation < 15°. Radiographic measurements and component features were compared between the two groups. RESULTS: A larger glenosphere size was associated with an excellent outcome (p = 0.009). A 2-mm posterior offset humeral cup (p = 0.012) and an increased inferior glenosphere overhang (3.1 mm vs 1.4 mm; p = 0.002) were also associated with excellent outcomes. Humeral lateralization and distalization were not associated with an excellent outcome. Conclusion: Larger glenosphere size and inferior positioning as well as posterior humeral offset are associated with improved postoperative range of motion following reverse shoulder arthroplasty. LEVEL OF EVIDENCE: Level 3, retrospective comparative study.
BACKGROUND: The purpose was to evaluate the relationship of component size and position to postoperative range of motion following reverse shoulder arthroplasty. The hypothesis was that increased lateralization, larger glenospheres, and a decreased acromiohumeral distance would be associated with excellent postoperative range of motion. METHODS: A retrospective multicenter study was performed at a minimum of one year postoperatively on 160 patients who underwent primary reverse shoulder arthroplasty with a 135° humeral component. Outcomes were stratified based on postoperative forward flexion and external rotation into excellent (n = 42), defined as forward flexion >140° and external rotation > 30°, or poor (n = 36), defined as forward flexion <100° and external rotation < 15°. Radiographic measurements and component features were compared between the two groups. RESULTS: A larger glenosphere size was associated with an excellent outcome (p = 0.009). A 2-mm posterior offset humeral cup (p = 0.012) and an increased inferior glenosphere overhang (3.1 mm vs 1.4 mm; p = 0.002) were also associated with excellent outcomes. Humeral lateralization and distalization were not associated with an excellent outcome. Conclusion: Larger glenosphere size and inferior positioning as well as posterior humeral offset are associated with improved postoperative range of motion following reverse shoulder arthroplasty. LEVEL OF EVIDENCE: Level 3, retrospective comparative study.
Authors: Sergio Gutiérrez; Jonathan C Levy; Mark A Frankle; Derek Cuff; Tony S Keller; Derek R Pupello; William E Lee Journal: J Shoulder Elbow Surg Date: 2008-03-06 Impact factor: 3.019
Authors: Carlo Felice De Biase; Giovanni Ziveri; Marco Delcogliano; Francesca de Caro; Stefano Gumina; Mario Borroni; Alessandro Castagna; Roberto Postacchini Journal: Int Orthop Date: 2013-06-09 Impact factor: 3.075