Effect of critical shoulder angle, glenoid lateralization, and humeral inclination on range of movement in reverse shoulder arthroplasty.
Journal article

Effect of critical shoulder angle, glenoid lateralization, and humeral inclination on range of movement in reverse shoulder arthroplasty.

  • Lädermann A Division of Orthopedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; Orthopedics and Trauma Service, University Hospitals of Geneva, Geneva, Switzerland.
  • Tay E Department of Orthopaedic Surgery, Ng Teng Fong General Hospital, Singapore, Singapore.
  • Collin P Centre Hospitalier Privé Saint-Grégoire (Vivalto Santé), Saint-Grégoire, France.
  • Piotton S Division of Orthopedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland.
  • Chiu CH Department of Orthopaedic Sports Medicine, Chang Gung Memorial Hospital, Taipei City, Taiwan.
  • Michelet A ReSurg SA, Nyon, Switzerland.
  • Charbonnier C University of Geneva, Geneva, Switzerland; Medical Research Department, Artanim Foundation, Geneva, Switzerland.
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  • 2019-09-21
Published in:
  • Bone & joint research. - 2019
English Objectives
To date, no study has considered the impact of acromial morphology on shoulder range of movement (ROM). The purpose of our study was to evaluate the effects of lateralization of the centre of rotation (COR) and neck-shaft angle (NSA) on shoulder ROM after reverse shoulder arthroplasty (RSA) in patients with different scapular morphologies.


Methods
3D computer models were constructed from CT scans of 12 patients with a critical shoulder angle (CSA) of 25°, 30°, 35°, and 40°. For each model, shoulder ROM was evaluated at a NSA of 135° and 145°, and lateralization of 0 mm, 5 mm, and 10 mm for seven standardized movements: glenohumeral abduction, adduction, forward flexion, extension, internal rotation with the arm at 90° of abduction, as well as external rotation with the arm at 10° and 90° of abduction.


Results
CSA did not seem to influence ROM in any of the models, but greater lateralization achieved greater ROM for all movements in all configurations. Internal and external rotation at 90° of abduction were impossible in most configurations, except in models with a CSA of 25°.


Conclusion
Postoperative ROM following RSA depends on multiple patient and surgical factors. This study, based on computer simulation, suggests that CSA has no influence on ROM after RSA, while lateralization increases ROM in all configurations. Furthermore, increasing subacromial space is important to grant sufficient rotation at 90° of abduction. In summary, increased lateralization of the COR and increased subacromial space improve ROM in all CSA configurations.Cite this article: A. Lädermann, E. Tay, P. Collin, S. Piotton, C-H Chiu, A. Michelet, C. Charbonnier. Effect of critical shoulder angle, glenoid lateralization, and humeral inclination on range of movement in reverse shoulder arthroplasty. Bone Joint Res 2019;8:378-386. DOI: 10.1302/2046-3758.88.BJR-2018-0293.R1.
Language
  • English
Open access status
gold
Identifiers
Persistent URL
https://sonar.ch/global/documents/43815
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