Do glenoid retroversion and humeral subluxation affect outcomes following total shoulder arthroplasty?

Abstract

Background Glenoid retroversion and humeral head subluxation have been suggested to lead to inferior outcomes after total shoulder arthroplasty (TSA). There are limited data to support this suggestion. We investigated whether preoperative glenoid retroversion and humeral head subluxation are associated with inferior outcomes after TSA and whether change of retroversion influences outcomes after TSA. Methods Patients undergoing TSA with minimum 2-year follow-up were included from a prospectively collected institutional shoulder arthroplasty database. Retroversion and humeral head subluxation before and after surgery were measured on axillary radiographs. Postoperative radiographs were -evaluated for glenoid component loosening and compared between groups. Spearman correlations were determined between retroversion measurements and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) scores. Patients were analyzed in groups based on retroversion and humeral head subluxation. Results There were 113 patients (50% follow-up rate) evaluated at 4.2 years postoperatively. The mean preoperative retroversion (15.3° ± 7.7°) was significantly higher than postoperative retroversion (10.0° ± 6.8°; P < .0001). There was no correlation between postoperative glenoid version or humeral head subluxation and ASES scores. For patients with preoperative retroversion of >15°, there was no difference in outcome scores based on postoperative retroversion. There were no differences in preoperative or postoperative version for patients with or without glenoid lucencies. Discussion We observed no significant relationship between postoperative glenoid retroversion or humeral head subluxation and clinical outcomes in patients following TSA. For patients with preoperative retroversion >15°, change of retroversion during TSA had no impact on their clinical outcomes at short-term follow-up.

Posterior decentering of the humeral head in patients with arthroscopic rotator cuff repair

“…In patients with rotator cuff dysfunction, PD can occur as a pre-stage pathology as a result of a similar mechanism to that of posterior HH subluxation in degenerative disease. Although posterior HH subluxation in degenerative disease is currently described as a percentage change from the midline of the scapula [ 22 , 23 ], PD in RCTs is a subtle change. Therefore, we defined PD as a greater than 2 mm posterior shift of the HH to the scapula, based on past studies [ 8 , 9 ].…”

Glenoid Component Position Does Not Affect Short-Term Clinical and Radiologic Outcomes in Total Shoulder Arthroplasty

“…Gregory et al confirmed that an inferiorly inclined glenoid component was associated with increased radiolucent lines [1]. Other research has shown no association between glenoid component version and clinical outcome scores [8,9]. For these reasons, it is important to examine and quantify the glenoid component position over time, and further, to determine whether glenoid component position impacts clinical or patient-reported outcomes.…”