Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
권호 표지
DOI QR코드

DOI QR Code

Comparative clinical and radiologic evaluation between patients undergoing standard reversed shoulder arthroplasty or bony increased offset

  • Tiago Amorim-Barbosa (Department of Orthopaedics, Centro Hospitalar Universitario do Porto, Hospital de Santo Antonio) ;
  • Ana Ribau (Department of Orthopaedics, Centro Hospitalar Universitario do Porto, Hospital de Santo Antonio) ;
  • Helder Fonte (Department of Orthopaedics, Centro Hospitalar Universitario do Porto, Hospital de Santo Antonio) ;
  • Luis Henrique Barros (Department of Orthopaedics, Centro Hospitalar Universitario do Porto, Hospital de Santo Antonio) ;
  • Rui Claro (Department of Orthopaedics, Centro Hospitalar Universitario do Porto, Hospital de Santo Antonio)
  • Received : 2022.10.03
  • Accepted : 2022.11.30
  • Published : 2023.03.01
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Modifications of the medialized design of Grammont-type reverse shoulder arthroplasty (RSA) using a bony increased offset (BIO-RSA) has shown better clinical results and fewer complications. The aim of this study is to compare the clinical results, complications, and radiological outcomes between patients undergoing standard RSA and BIO-RSA. Methods: A retrospective review was performed of 42 RSA procedures (22 standard RSA and 20 BIO-RSA). With a minimum of 1 year of follow-up, range of motion (ROM), Constant shoulder score (CSS), visual analog scale (VAS), and subjective shoulder score (SSS) were compared. Radiographs and computed tomography (CT) scan were examined for scapular notching, glenoid and humeral fixation, and graft healing. Results: At a mean follow-up of 27.6 months (range, 12-48 months), a significant difference was found for active-internal rotation (P=0.038) and for passive-external rotation (P=0.013), with better results in BIO-RSA. No other differences were found in ROM, CSS (P=0.884), VAS score, and SSS. Graft healing and viability were verified in all patients with CT scan (n=34). The notching rate was 28% in the standard RSA group and 33% in the BIO-RSA group, but the standard RSA had more severe notching (grade 2) than BIO-RSA (P=0.039). No other significative differences were found in glenoid and humeral fixation. Conclusions: Bone-graft lateralization is associated with better internal and external rotation and with less severe scapular notching compared to the standard RSA. Integration of the bone graft occurs effectively, with no relevant changes observed on radiographic evaluation. Level of evidence: III.

Keywords

References

  1. Tashjian RZ, Burks RT, Zhang Y, Henninger HB. Reverse total shoulder arthroplasty: a biomechanical evaluation of humeral and glenosphere hardware configuration. J Shoulder Elbow Surg 2015;24:e68-77. https://doi.org/10.1016/j.jse.2014.08.017
  2. Greiner S, Schmidt C, Konig C, Perka C, Herrmann S. Lateralized reverse shoulder arthroplasty maintains rotational function of the remaining rotator cuff. Clin Orthop Relat Res 2013;471:940-6. https://doi.org/10.1007/s11999-012-2692-x
  3. Gutierrez S, Comiskey CA, Luo ZP, Pupello DR, Frankle MA. Range of impingement-free abduction and adduction deficit after reverse shoulder arthroplasty: hierarchy of surgical and implant-design-related factors. J Bone Joint Surg Am 2008;90:2606-15. https://doi.org/10.2106/JBJS.H.00012
  4. Gutierrez S, Walker M, Willis M, Pupello DR, Frankle MA. Effects of tilt and glenosphere eccentricity on baseplate/bone interface forces in a computational model, validated by a mechanical model, of reverse shoulder arthroplasty. J Shoulder Elbow Surg 2011;20:732-9. https://doi.org/10.1016/j.jse.2010.10.035
  5. Werner BS, Chaoui J, Walch G. The influence of humeral neck shaft angle and glenoid lateralization on range of motion in reverse shoulder arthroplasty. J Shoulder Elbow Surg 2017;26:1726-31. https://doi.org/10.1016/j.jse.2017.03.032
  6. de Wilde LF, Poncet D, Middernacht B, Ekelund A. Prosthetic overhang is the most effective way to prevent scapular conflict in a reverse total shoulder prosthesis. Acta Orthop 2010;81:719-26. https://doi.org/10.3109/17453674.2010.538354
  7. Theivendran K, Varghese M, Large R, et al. Reverse total shoulder arthroplasty using a trabecular metal glenoid base plate: functional and radiological outcomes at two to five years. Bone Joint J 2016;98:969-75.
  8. Boileau P, Morin-Salvo N, Bessiere C, Chelli M, Gauci MO, Lemmex DB. Bony increased-offset-reverse shoulder arthroplasty: 5 to 10 years' follow-up. J Shoulder Elbow Surg 2020;29:2111-22. https://doi.org/10.1016/j.jse.2020.02.008
  9. Boileau P, Moineau G, Roussanne Y, O'Shea K. Bony increased-offset reversed shoulder arthroplasty: minimizing scapular impingement while maximizing glenoid fixation. Clin Orthop Relat Res 2011;469:2558-67. https://doi.org/10.1007/s11999-011-1775-4
  10. Athwal GS, MacDermid JC, Reddy KM, Marsh JP, Faber KJ, Drosdowech D. Does bony increased-offset reverse shoulder arthroplasty decrease scapular notching. J Shoulder Elbow Surg 2015;24:468-73. https://doi.org/10.1016/j.jse.2014.08.015
  11. Collin P, Liu X, Denard PJ, Gain S, Nowak A, Ladermann A. Standard versus bony increased-offset reverse shoulder arthroplasty: a retrospective comparative cohort study. J Shoulder Elbow Surg 2018;27:59-64. https://doi.org/10.1016/j.jse.2017.07.020
  12. Greiner S, Schmidt C, Herrmann S, Pauly S, Perka C. Clinical performance of lateralized versus non-lateralized reverse shoulder arthroplasty: a prospective randomized study. J Shoulder Elbow Surg 2015;24:1397-404. https://doi.org/10.1016/j.jse.2015.05.041
  13. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 1987;(214):160-4.
  14. Gilbart MK, Gerber C. Comparison of the subjective shoulder value and the Constant score. J Shoulder Elbow Surg 2007;16:717-21. https://doi.org/10.1016/j.jse.2007.02.123
  15. Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Mole D. Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff: results of a multicentre study of 80 shoulders. J Bone Joint Surg Br 2004;86:388-95. https://doi.org/10.1302/0301-620X.86B3.14024
  16. Sperling JW, Cofield RH, O'Driscoll SW, Torchia ME, Rowland CM. Radiographic assessment of ingrowth total shoulder arthroplasty. J Shoulder Elbow Surg 2000;9:507-13. https://doi.org/10.1067/mse.2000.109384
  17. Henninger HB, Barg A, Anderson AE, Bachus KN, Tashjian RZ, Burks RT. Effect of deltoid tension and humeral version in reverse total shoulder arthroplasty: a biomechanical study. J Shoulder Elbow Surg 2012;21:483-90. https://doi.org/10.1016/j.jse.2011.01.040
  18. Valenti P, Sauzieres P, Katz D, Kalouche I, Kilinc AS. Do less medialized reverse shoulder prostheses increase motion and reduce notching. Clin Orthop Relat Res 2011;469:2550-7. https://doi.org/10.1007/s11999-011-1844-8
  19. Ackland DC, Richardson M, Pandy MG. Axial rotation moment arms of the shoulder musculature after reverse total shoulder arthroplasty. J Bone Joint Surg Am 2012;94:1886-95. https://doi.org/10.2106/JBJS.J.01861
  20. Li X, Knutson Z, Choi D, et al. Effects of glenosphere positioning on impingement-free internal and external rotation after reverse total shoulder arthroplasty. J Shoulder Elbow Surg 2013;22:807-13.  https://doi.org/10.1016/j.jse.2012.07.013