Is limited external rotation after reverse shoulder arthroplasty associated with glenoidal notching?: An observational study; [Geht eine eingeschränkte Außenrotation nach inverser Schulterendoprothetik mit glenoidalem Notching einher?: Eine Beobachtungsstudie]

被引：0

作者：

Grob A. ^{[1
,2
]}

Bouaicha S. ^{[1
]}

Germann M. ^{[1
,3
]}

Germann S. ^{[4
]}

Gerber C. ^{[1
]}

Wieser K. ^{[1
]}

机构：

[1] Department of Orthopaedics, Balgrist University Hospital, Zurich

[2] Department of Neurosurgery, University Hospital Zurich, Frauenklinikstr. 10, Zurich

[3] Department of Spine Surgery, University Hospital, Vaud

[4] Department of Foot and Ankle Surgery, Hospital Biel, Biel

来源：

Obere Extremität | 2021年 / 16卷 / 4期

关键词：

External rotation; Scapular notching; Shoulder Pain; Sirveaux; Subjective Shoulder Value;

D O I：

10.1007/s11678-021-00668-3

中图分类号：

学科分类号：

摘要：

Background: Reverse shoulder arthroplasty (RSA) is a valuable solution for patients with shoulder pain or injury primarily due to a rotator cuff tear or secondary to traumatic events. Nevertheless, several complications are known to appear, with the most frequent being scapular notching (SN) on the inferior and posterior scapular neck. Controversial data exist about the clinical relevance of SN. Since further consequences are still not clearly understood, we aimed to provide more clarity on which factors, especially external rotation (ER), contribute to the appearance and progress of notching. Methods: Constant Score (CS), Subjective Shoulder Value (SSV), flexion, abduction, and ER were evaluated retrospectively in 153 shoulders of 147 patients (mean age 79±7.7 years; 62% women) who underwent RSA between 2005 and 2010. Anteroposterior radiographs were evaluated before and 1, 2, 3, and 5 years after RSA for SN according to the Sirveaux classification. The evaluation was performed by two independent surgeons. Spearman’s coefficient and t-test were used. Results: CS, SSV, flexion, and abduction increased significantly 1 year after RSA compared to before (all p < 0.0001). No improvement was shown for ER between the same timepoints. Between 2 and 5 years of follow-up, only flexion decreased by 5°(p = 0.02) while CS, SSV, abduction, and ER remained constant. After RSA, notching increases over time. There was no association between SN and CS, SSV, flexion, abduction or ER at any of the measured timepoints. Higher flexion correlated with higher abduction after RSA at every follow-up (1 year r = 0.88, 2 years r = 0.89, 3 years r = 0.86, 5 years r = 0.86). The interrater correlation test showed a strong correlation (r = 0.7). Conclusion: We verified the functional benefits of RSA for patients. Additionally, our findings show that despite radiographic progression of notching and unchanged limited ER, the postoperative improvements in CS, SSV, flexion, and abduction are preserved over 5 years. © 2021, The Author(s).

引用

页码：272 / 280

页数：8

共 42 条

[1]

Berglund D.D., Rosas S., Triplet J.J., Kurowicki J., Horn B., Levy J.C., Restoration of external rotation following reverse shoulder arthroplasty without latissimus dorsi transfer, JB JS Open Access, 3, (2018)

[2]

Boileau P., Chuinard C., Roussanne Y., Neyton L., Trojani C., Modified latissimus dorsi and teres major transfer through a single delto-pectoral approach for external rotation deficit of the shoulder: as an isolated procedure or with a reverse arthroplasty, J Shoulder Elbow Surg, 16, pp. 671-682, (2007)

[3]

Boileau P., Gonzalez J.F., Chuinard C., Bicknell R., Walch G., Reverse total shoulder arthroplasty after failed rotator cuff surgery, J Shoulder Elbow Surg, 18, pp. 600-606, (2009)

[4]

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, 469, pp. 2558-2567, (2011)

[5]

Boileau P., Rumian A.P., Zumstein M.A., Reversed shoulder arthroplasty with modified L’Episcopo for combined loss of active elevation and external rotation, J Shoulder Elbow Surg, 19, pp. 20-30, (2010)

[6]

Boileau P., Watkinson D.J., Hatzidakis A.M., Balg F., Grammont reverse prosthesis: design, rationale, and biomechanics, J Shoulder Elbow Surg, 14, pp. 147S-161S, (2005)

[7]

Cappellari A., Trovarelli G., Andriolo M., Berizzi A., Ruggieri P., Reverse shoulder arthroplasty for treatment of proximal humerus complex fractures in elderly: a single institution experience, Injury, (2020)

[8]

Carofino B., Routman H., Roche C., The influence of preoperative external rotation weakness or stiffness on reverse total shoulder arthroplasty, JSES Int, 4, pp. 382-387, (2020)

[9]

Clark J.C., Ritchie J., Song F.S., Kissenberth M.J., Tolan S.J., Hart N.D., Hawkins R.J., Complication rates, dislocation, pain, and postoperative range of motion after reverse shoulder arthroplasty in patients with and without repair of the subscapularis, J Shoulder Elbow Surg, 21, pp. 36-41, (2012)

[10]

De Wilde L., Audenaert E., Barbaix E., Audenaert A., Soudan K., Consequences of deltoid muscle elongation on deltoid muscle performance: a computerised study, Clin Biomech (Bristol, Avon), 17, pp. 499-505, (2002)

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