Journal article
Glenosphere size in reverse shoulder arthroplasty: is larger better for external rotation and abduction strength?
- Müller AM Research and Development Department, Schulthess Clinic, Zürich, Switzerland; Department of Orthopaedic Surgery and Traumatology, University Hospital of Basel, Basel, Switzerland.
- Born M Research and Development Department, Schulthess Clinic, Zürich, Switzerland; Department of Orthopaedic Surgery and Traumatology, University Hospital of Basel, Basel, Switzerland.
- Jung C Upper Extremities Department, Schulthess Clinic, Zürich, Switzerland.
- Flury M Upper Extremities Department, Schulthess Clinic, Zürich, Switzerland.
- Kolling C Research and Development Department, Schulthess Clinic, Zürich, Switzerland; Upper Extremities Department, Schulthess Clinic, Zürich, Switzerland.
- Schwyzer HK Upper Extremities Department, Schulthess Clinic, Zürich, Switzerland.
- Audigé L Research and Development Department, Schulthess Clinic, Zürich, Switzerland; Upper Extremities Department, Schulthess Clinic, Zürich, Switzerland. Electronic address: laurent.audige@kws.ch.
- 2017-07-28
Published in:
- Journal of shoulder and elbow surgery. - 2018
Shoulder
arthroplasty
functional outcomes
glenosphere size
radiographic outcomes
reverse shoulder replacement
Aged
Arthroplasty, Replacement, Shoulder
Biomechanical Phenomena
Female
Follow-Up Studies
Humans
Male
Middle Aged
Muscle Strength
Prosthesis Design
Radiography
Range of Motion, Articular
Retrospective Studies
Rotation
Scapula
Shoulder Joint
Shoulder Pain
Shoulder Prosthesis
Time Factors
English
BACKGROUND
The role of glenosphere size in reverse shoulder arthroplasty (RSA) may be important in prosthetic stability, joint kinematics, rotator cuff tension and excursion, scapular impingement, humeral lateralization, deltoid wrap, and the occurrence of "notching." This study compared short- and midterm clinical and radiographic outcomes for 2 different glenosphere sizes of a single RSA type with respect to implant positioning, glenoid size, and morphology.
METHODS
This retrospective analysis included 68 RSA procedures that were prospectively documented in a local register during a 5-year postoperative period. Two glenosphere diameter sizes of 36 mm (n = 33) and 44 mm (n = 35) were used. Standard radiographs were made preoperatively (ie, baseline) and at 6, 12, 24, and 60 months after surgery. Range of motion, strength, the Constant-Murley score, and the Shoulder Pain and Disability Index were also assessed at all follow-up visits. The effect of glenosphere size on measured outcomes was adjusted for baseline values, patient gender, and humeral head diameter.
RESULTS
No significant differences were found in the functional scores between treatment groups at all follow-up assessments. At the 12-month follow-up, patients with a 44-mm glenosphere had greater external rotation in adduction (mean difference, 12°; P = .001) and abduction strength (mean difference, 1.4 kg; P = .026) compared with those with the smaller implant. These differences remained at 60 months. Scapular notching was observed in 38% of all patients, without any relevant difference between the groups.
CONCLUSION
An increase in glenosphere diameter leads to a clinically moderate but significant increase in external rotation in adduction and abduction strength at midterm follow-up.
The role of glenosphere size in reverse shoulder arthroplasty (RSA) may be important in prosthetic stability, joint kinematics, rotator cuff tension and excursion, scapular impingement, humeral lateralization, deltoid wrap, and the occurrence of "notching." This study compared short- and midterm clinical and radiographic outcomes for 2 different glenosphere sizes of a single RSA type with respect to implant positioning, glenoid size, and morphology.
METHODS
This retrospective analysis included 68 RSA procedures that were prospectively documented in a local register during a 5-year postoperative period. Two glenosphere diameter sizes of 36 mm (n = 33) and 44 mm (n = 35) were used. Standard radiographs were made preoperatively (ie, baseline) and at 6, 12, 24, and 60 months after surgery. Range of motion, strength, the Constant-Murley score, and the Shoulder Pain and Disability Index were also assessed at all follow-up visits. The effect of glenosphere size on measured outcomes was adjusted for baseline values, patient gender, and humeral head diameter.
RESULTS
No significant differences were found in the functional scores between treatment groups at all follow-up assessments. At the 12-month follow-up, patients with a 44-mm glenosphere had greater external rotation in adduction (mean difference, 12°; P = .001) and abduction strength (mean difference, 1.4 kg; P = .026) compared with those with the smaller implant. These differences remained at 60 months. Scapular notching was observed in 38% of all patients, without any relevant difference between the groups.
CONCLUSION
An increase in glenosphere diameter leads to a clinically moderate but significant increase in external rotation in adduction and abduction strength at midterm follow-up.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.jse.2017.06.002
- PMID 28747277
- Persistent URL
- https://roar.hep-bejune.ch/global/documents/102245
Statistics
Document views: 12
File downloads: