Influence of scapular neck length on the extent of impingement-free adduction after reverse total shoulder arthroplasty.
Reverse total shoulder arthroplasty
adduction
glenoid offset
onlay design
preoperative planning
scapular neck length
Journal
Journal of shoulder and elbow surgery
ISSN: 1532-6500
Titre abrégé: J Shoulder Elbow Surg
Pays: United States
ID NLM: 9206499
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
18
02
2021
revised:
27
06
2021
accepted:
11
07
2021
pubmed:
15
8
2021
medline:
15
12
2021
entrez:
14
8
2021
Statut:
ppublish
Résumé
Following reverse total shoulder arthroplasty, a short scapular neck length (SNL) decreases postoperative impingement-free adduction, and impingement between the neck of the scapula and the humeral polyethylene cup may cause scapular notching. However, no reports have evaluated the influence of SNL on impingement-free adduction. The purposes of this study were to evaluate the influence of SNL on impingement-free adduction and to examine the effect of glenoid component lateralization and inferiorization on impingement-free adduction. By use of 3-dimensional templating software, a virtual reverse total shoulder arthroplasty model was created in 15 patients who had no osteoarthritic change or any other bony deformity. We measured SNLs separately before implant placement (preoperative SNL) and after implant placement (postoperative SNL). The implant used was the Comprehensive Reverse Shoulder System (Zimmer Biomet, Warsaw, IN, USA), and baseplate bony lateralization of 0, 5, and 10 mm, with inferior eccentricity of 0.5 or 4.5 mm, was tested for impingement-free adduction. Correlations between the preoperative and postoperative SNLs and impingement-free adduction were analyzed. The mean preoperative SNL was 8.2 ± 1.9 mm (range, 5.0-11.7 mm), and the mean postoperative SNL was 6.0 ± 2.0 mm (range, 2.1-9.8 mm). There was a moderate correlation between the preoperative SNL and impingement-free adduction (r = 0.628, P = .12) and a strong correlation between the postoperative SNL and impingement-free adduction (r = 0.771, P = .001). Use of the model with 10 mm of bony lateralization and 4.5 mm of inferior eccentricity provided the best results in terms of impingement-free adduction. There were correlations between both the preoperative and postoperative SNLs and impingement-free adduction. Although the lateralized and inferiorized center of rotation may increase the risk of loosening of the glenoid component, this offset significantly increased impingement-free adduction.
Sections du résumé
BACKGROUND
BACKGROUND
Following reverse total shoulder arthroplasty, a short scapular neck length (SNL) decreases postoperative impingement-free adduction, and impingement between the neck of the scapula and the humeral polyethylene cup may cause scapular notching. However, no reports have evaluated the influence of SNL on impingement-free adduction. The purposes of this study were to evaluate the influence of SNL on impingement-free adduction and to examine the effect of glenoid component lateralization and inferiorization on impingement-free adduction.
METHODS
METHODS
By use of 3-dimensional templating software, a virtual reverse total shoulder arthroplasty model was created in 15 patients who had no osteoarthritic change or any other bony deformity. We measured SNLs separately before implant placement (preoperative SNL) and after implant placement (postoperative SNL). The implant used was the Comprehensive Reverse Shoulder System (Zimmer Biomet, Warsaw, IN, USA), and baseplate bony lateralization of 0, 5, and 10 mm, with inferior eccentricity of 0.5 or 4.5 mm, was tested for impingement-free adduction. Correlations between the preoperative and postoperative SNLs and impingement-free adduction were analyzed.
RESULTS
RESULTS
The mean preoperative SNL was 8.2 ± 1.9 mm (range, 5.0-11.7 mm), and the mean postoperative SNL was 6.0 ± 2.0 mm (range, 2.1-9.8 mm). There was a moderate correlation between the preoperative SNL and impingement-free adduction (r = 0.628, P = .12) and a strong correlation between the postoperative SNL and impingement-free adduction (r = 0.771, P = .001). Use of the model with 10 mm of bony lateralization and 4.5 mm of inferior eccentricity provided the best results in terms of impingement-free adduction.
CONCLUSION
CONCLUSIONS
There were correlations between both the preoperative and postoperative SNLs and impingement-free adduction. Although the lateralized and inferiorized center of rotation may increase the risk of loosening of the glenoid component, this offset significantly increased impingement-free adduction.
Identifiants
pubmed: 34390842
pii: S1058-2746(21)00584-X
doi: 10.1016/j.jse.2021.07.005
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
185-191Informations de copyright
Copyright © 2021 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.