دورية أكاديمية
أعرض في EDS

The effect of glenosphere lateralization and inferiorization on deltoid force in reverse total shoulder arthroplasty.

التفاصيل البيبلوغرافية
العنوان: The effect of glenosphere lateralization and inferiorization on deltoid force in reverse total shoulder arthroplasty.
المؤلفون: Nolte PC; Department of Biomedical Engineering, Steadman Philippon Research Institute, Vail, CO, USA; Department of Trauma and Orthopaedic Surgery, Clinic for Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen at the University of Heidelberg, Ludwigshafen, Germany., Miles JW; Department of Biomedical Engineering, Steadman Philippon Research Institute, Vail, CO, USA., Tanghe KK; Department of Biomedical Engineering, Steadman Philippon Research Institute, Vail, CO, USA., Brady AW; Department of Biomedical Engineering, Steadman Philippon Research Institute, Vail, CO, USA., Midtgaard KS; Department of Biomedical Engineering, Steadman Philippon Research Institute, Vail, CO, USA; Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway; Norwegian Armed Forces Joint Medical Services, Oslo, Norway., Cooper JD; Department of Biomedical Engineering, Steadman Philippon Research Institute, Vail, CO, USA; The Steadman Clinic, Vail, CO, USA., Lacheta L; Department of Biomedical Engineering, Steadman Philippon Research Institute, Vail, CO, USA; Center for Musculoskeletal Surgery, Charité Universitaetsmedizin Berlin, Berlin, Germany., Provencher MT; Department of Biomedical Engineering, Steadman Philippon Research Institute, Vail, CO, USA; The Steadman Clinic, Vail, CO, USA., Millett PJ; Department of Biomedical Engineering, Steadman Philippon Research Institute, Vail, CO, USA; The Steadman Clinic, Vail, CO, USA. Electronic address: drmillett@thesteadmanclinic.com.
المصدر: Journal of shoulder and elbow surgery [J Shoulder Elbow Surg] 2021 Aug; Vol. 30 (8), pp. 1817-1826. Date of Electronic Publication: 2020 Dec 05.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Mosby Country of Publication: United States NLM ID: 9206499 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-6500 (Electronic) Linking ISSN: 10582746 NLM ISO Abbreviation: J Shoulder Elbow Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: St. Louis, MO : Mosby
Original Publication: St. Louis, MO : Mosby Yearbook, Inc., c1992-
مواضيع طبية MeSH: Arthroplasty, Replacement, Shoulder* , Shoulder Joint*/surgery , Shoulder Prosthesis*, Biomechanical Phenomena ; Cadaver ; Deltoid Muscle/surgery ; Humans ; Range of Motion, Articular
مستخلص: Background: A medialized center of rotation (COR) in reverse total shoulder arthroplasty (RTSA) comes with limitations such as scapular notching and reduced range of motion. To mitigate these effects, lateralization and inferiorization of the COR are performed, but may adversely affect deltoid muscle force. The study purposes were to measure the effect of RTSA with varying glenosphere configurations on (1) the COR and (2) deltoid force compared with intact shoulders and shoulders with massive posterosuperior rotator cuff tears (PS-RCT). We hypothesized that the highest deltoid forces would occur in shoulders with PS-RCT, and that RTSA would lead to a decrease in required forces that is further minimized with lateralization and inferiorization of the COR but still higher compared with native shoulders with an intact rotator cuff.
Methods: In this study, 8 cadaveric shoulders were dissected leaving only the rotator cuff muscles and capsule intact. A custom apparatus incorporating motion capture and a dynamic tensile testing machine to measure the changes in COR and deltoid forces while simultaneously recording glenohumeral abduction was designed. Five consecutive testing states were tested: (1) intact shoulder, (2) PS-RCT, (3) RTSA with standard glenosphere, (4) RTSA with 4 mm lateralized glenosphere, and (5) RTSA with 2.5 mm inferiorized glenosphere. Statistical Parametric Mapping was used to analyze the deltoid force as a function of the abduction angle. One-way repeated-measures within-specimens analysis of variance was conducted, followed by post hoc t-tests for pairwise comparisons between the states.
Results: All RTSA configurations shifted the COR medially and inferiorly with respect to native (standard: 4.2 ± 2.1 mm, 19.7 ± 3.6 mm; 4 mm lateralized: 3.9 ± 1.2 mm, 16.0 ± 1.8; 2.5 mm inferiorized: 6.9 ± 0.9 mm, 18.9 ± 1.7 mm). Analysis of variance showed a significant effect of specimen state on deltoid force across all abduction angles. Of the 10 paired t-test comparisons made between states, only 3 showed significant differences: (1) intact shoulders necessitated significantly lower deltoid force than specimens with PS-RCT below 42° abduction, (2) RTSAs with standard glenospheres required significantly lower deltoid force than RTSA with 4 mm lateralized glenospheres above 34° abduction, and (3) RTSAs with 2.5 mm inferiorized glenospheres had significantly lower deltoid force than RTSA with 4 mm of glenosphere lateralization at higher abduction angles.
Conclusions: RTSA with a 2.5 mm inferiorized glenosphere and no additional lateralization resulted in less deltoid force to abduct the arm compared with 4 mm lateralized glenospheres. Therefore, when aiming to mitigate downsides of a medialized COR, an inferiorized glenosphere may be preferable in terms of its effect on deltoid force.
(Copyright © 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Inverse shoulder arthroplasty; cuff tear arthropathy; distalization; massive rotator cuff tears; reverse shoulder prosthesis; statistical parametric mapping
تواريخ الأحداث: Date Created: 20201208 Date Completed: 20210728 Latest Revision: 20210728
رمز التحديث: 20240628
DOI: 10.1016/j.jse.2020.10.038
PMID: 33290849
قاعدة البيانات: MEDLINE
الوصف
تدمد:1532-6500
DOI:10.1016/j.jse.2020.10.038