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Humeral head size predicts baseplate lateralization in reverse shoulder arthroplasty: a comparative computer model study.

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العنوان: Humeral head size predicts baseplate lateralization in reverse shoulder arthroplasty: a comparative computer model study.
المؤلفون: Bauer S; Chirurgie de l'épaule et du coude, Service d'Orthopédie et de Traumatologie, Ensemble Hospitalier de la Côte, Morges, Switzerland.; School of Surgery, University of Western Australia, Perth, WA, Australia., Blakeney WG; School of Surgery, University of Western Australia, Perth, WA, Australia.; Department of Orthopaedic Surgery, Royal Perth Hospital, Perth, WA, Australia., Meylan A; Chirurgie de l'épaule et du coude, Service d'Orthopédie et de Traumatologie, Ensemble Hospitalier de la Côte, Morges, Switzerland.; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland., Mahlouly J; Chirurgie de l'épaule et du coude, Service d'Orthopédie et de Traumatologie, Ensemble Hospitalier de la Côte, Morges, Switzerland., Wang AW; School of Surgery, University of Western Australia, Perth, WA, Australia., Walch A; CHU de Lyon, Groupement Hospitalier Edouard Herriot, Lyon, France., Tolosano L; Chirurgie de l'épaule et du coude, Service d'Orthopédie et de Traumatologie, Ensemble Hospitalier de la Côte, Morges, Switzerland.; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
المصدر: JSES international [JSES Int] 2023 Dec 14; Vol. 8 (2), pp. 335-342. Date of Electronic Publication: 2023 Dec 14 (Print Publication: 2024).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier, Inc Country of Publication: United States NLM ID: 101763461 Publication Model: eCollection Cited Medium: Internet ISSN: 2666-6383 (Electronic) Linking ISSN: 26666383 NLM ISO Abbreviation: JSES Int Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [New York] : Elsevier, Inc., [2020]-
مستخلص: Background: In reverse shoulder arthroplasty (RSA), the ideal combination of baseplate lateralization (BL), glenosphere size (GS), and glenosphere overhang (GOH) with a commonly used 145° neck shaft angle (NSA) is unclear. This is the first study evaluating correlations of body height (BH), humeral head size (HS), glenoid height (GH), and association of gender with best glenoid configurations for range of motion (ROM) maintaining anatomic lateralization (aLAT) for optimized muscle length in 145° and less distalized 135° RSA.
Methods: In this computer model study, 22 computed tomographies without joint narrowing were analyzed (11 male/female). A standardized semi-inlay 145° platform stem was combined with 20 glenoid configurations (baseplate [B] 25, 25 + 3/+6 lateralized [l], 29, 29 + 3/6l combined with glenosphere 36, 36 + 2 eccentric [e], 36 + 3l, 39, 39 + 3e, 39 + 3l , 42, 42 + 4e). Abduction-adduction, flexion-extension, external rotation-internal rotation, total ROM (TROM), and total notching relevant (TNR) ROM were computed, best TROM models respecting aLAT (-1 mm to +1 mm) and HS/GH recorded. Second, the 145° models (Ascend Flex stem; Stryker, Kalamazoo, MI, USA) were converted and compared to a 135° inlay RSA (New Perform stem; Stryker, Kalamazoo, MI, USA) maintaining GOH (6.5-7 mm) and aLAT.
Results: Best 145° models had eccentric glenospheres (mean BL: 3.5 mm, GOH 8.8 mm, GS 38.1 mm, distalization 23 mm). The 135° models had concentric glenospheres, mean BL 3.8 mm, GOH 6.9 mm, GS 39.7 mm, and distalization 14.1 mm. HS showed the strongest positive correlation with BL in 145° and 135° models (0.65/0.79). Despite reduced GOH in smaller females with a 135° NSA, adduction, external rotation, extension, TNR ROM, and TROM were significantly increased ( P  = .02, P  = .005, P  = .005, P  = .004, P  = .003), abduction however reduced ( P  = .02). The same trends were seen for males.
Conclusion: HS is a practical measure in surgery or preoperatively, and the strong positive correlation with BL is a useful planning aid. Despite reduction of GOH, conversion to a less distalized 135° NSAinlay design is powerful to maintain and even significantly increase all components of TNR ROM (extension/external rotation/adduction) in small females with the drawback of reduced abduction which may however be compensated by scapula motion. Lateralization with a less distalized 135° RSA optimizes muscle length, may facilitate subscapularis repair, and maintains highest rigid body motion.
(© 2023 The Authors.)
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فهرسة مساهمة: Keywords: Body height; Distalization; Glenosphere size; Native humeral head size; Neck shaft angle; Neutral anatomic lateralization; Notching; Reverse shoulder arthroplasty
تواريخ الأحداث: Date Created: 20240311 Latest Revision: 20240312
رمز التحديث: 20240312
مُعرف محوري في PubMed: PMC10920133
DOI: 10.1016/j.jseint.2023.11.015
PMID: 38464453
قاعدة البيانات: MEDLINE
الوصف
تدمد:2666-6383
DOI:10.1016/j.jseint.2023.11.015