Effects of glenosphere positioning on impingement-free internal and external rotation after reverse total shoulder arthroplasty.

نویسندگان

  • Xinning Li
  • Zakary Knutson
  • Daniel Choi
  • Daniel Lobatto
  • Joseph Lipman
  • Edward V Craig
  • Russell F Warren
  • Lawrence V Gulotta
چکیده

INTRODUCTION Patients may experience a loss of internal rotation (IR) and external rotation (ER) after reverse total shoulder arthroplasty (RTSA). We hypothesized that alterations in the glenosphere position will affect the amount of impingement-free IR and ER. MATERIALS AND METHODS Computed tomography (CT) scans of the scapula and humerus were obtained from 7 cadaveric specimens, and 3-dimensional reconstructions were created. RTSA models were virtually implanted into each specimen. The glenosphere position was determined in relation to the neutral position in 7 settings: medialization (5 mm), lateralization (10 mm), superior translation (6 mm), inferior translation (6 mm), superior tilt (20°), and inferior tilt (15° and 30°). The humerus in each virtual model was allowed to freely rotate at a fixed scaption angle (0°, 20°, 40°, and 60°) until encountering bone-to-bone or bone-to-implant impingement (180° of limitation). Measurements were recorded for each scaption angulation. RESULTS At 0° scaption, only inferior translation, lateralization, and inferior tilt (30°) allowed any impingement-free motion in IR and ER. At the midranges of scaption (20° and 40°), increased lateralization and inferior translation resulted in improved rotation. Supraphysiologic motion (>90° rotation) was seen consistently at 60° of scaption in IR. Superior translation (6 mm) resulted in no rotation at 0° and 20° of scaption for IR and ER. CONCLUSIONS Glenosphere position significantly affected humeral IR and ER after RTSA. Superior translation resulted in significant restrictions on IR and ER. Optimal glenosphere positioning was achieved with inferior translation, inferior tilt, and lateralization in all degrees of scaption.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Anterior and Posterior Scapular Impingement Associated with Two Different Reverse Shoulder Designs

Introduction Reverse shoulder arthroplasty is an increasingly popular treatment option for cuff tear arthropathy and other degenerative conditions of the glenohumeral joint that have been previously treated with limited success. Concerns about scapular notching have driven design and surgical technique modifications by manufacturers and surgeons in order to improve range of motion (ROM) and sta...

متن کامل

Influence of glenoid component design and humeral component retroversion on internal and external rotation in reverse shoulder arthroplasty: a cadaver study.

BACKGROUND A common disadvantage of reverse shoulder arthroplasty is limitation of the range of arm rotation. Several changes to the prosthesis design and implantation technique have been suggested to improve rotation range of motion (ROM). HYPOTHESIS Glenoid component design and degree of humeral component retroversion influence rotation ROM after reverse shoulder arthroplasty. MATERIAL AN...

متن کامل

Effect of baseplate size on primary glenoid stability and impingement-free range of motion in reverse shoulder arthroplasty

BACKGROUND Use of a baseplate with a smaller diameter in reverse shoulder arthroplasty is increasing, especially in patients with a small glenoid or glenoid wear. However, the effect of a smaller baseplate on stability of the glenoid component has not been evaluated. Thus, the purpose of this study was to determine whether a smaller baseplate (25 mm) is beneficial to the initial stability of th...

متن کامل

Activities of daily living with reverse prostheses: importance of scapular compensation for functional mobility of the shoulder.

HYPOTHESIS The nonanatomical design of reverse shoulder prostheses induce medial displacement of the center of rotation, impingements and may reduce the mobility of the shoulder. The aim of this study is to test the hypothesis that during activities of daily living functional mobility of the shoulder can be restored by scapular compensation. MATERIAL AND METHODS A numerical 3-dimensional mode...

متن کامل

Early Versus Late Reverse Shoulder Arthroplasty for Proximal Humerus Fractures: Does It Matter?

Background: This study compared the outcomes between patients with proximal humerus fractures (PHF) whounderwent acute reverse total shoulder arthroplasty (RSA) to those who underwent an alternative initial treatmentbefore requiring (secondary) RSA.Methods: Patients who underwent RSA after suffering a PHF were identified. Two year clinical follow-up was requiredfor inclusion. Patients were divi...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Journal of shoulder and elbow surgery

دوره 22 6  شماره 

صفحات  -

تاریخ انتشار 2013