Does lateralizing the glenosphere center of rotation by 4 mm decrease scapular notching in reverse shoulder arthroplasty with a 135° humeral component?

Harmsen, Samuel; Robaina, Joey; Campbell, David H.; Denard, Patrick J.; Gobezie, Reuben; Lederman, Evan

doi:10.1016/j.jseint.2021.12.005

Cited by 6 publications

(1 citation statement)

References 37 publications

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“…By contrast, Berglund et al 15 reviewed 33 lateralized RSAs performed in patients with a preoperative ER deficit (active ER <0°) and at least 2 years of follow-up and found no relationship between teres minor atrophy and the restoration of ER. Other authors have corroborated Berglund's findings in patients with loss of ER, albeit non-CLEER patients, suggesting that lateralization alone is sufficient to restore ER 47,48 , while some studies (also non-CLEER) have found no difference in rotation with a lateralized RSA design 16,49 . In this study, mean postoperative ER was similar in lateralized and medialized RSA (23° vs. 20°; Fig.…”

Section: Discussionmentioning

confidence: 62%

Outcomes of Reverse Total Shoulder Arthroplasty with Latissimus Dorsi Tendon Transfer for External Rotation Deficit

Hones¹,

Rakauskas²,

Wright³

et al. 2023

JBJS Reviews

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Background: Latissimus dorsi transfer (LDT) has been purported to restore motion in patients undergoing reverse shoulder arthroplasty (RSA) who have preoperative combined loss of forward elevation (FE) and external rotation (ER). This systematic review summarizes the available evidence for the functional outcomes and complications after RSA with LDT. Furthermore, the effect of implant design and whether a concomitant teres major transfer (TMT) was performed were studied.Methods: A systematic review was performed per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We queried PubMed/MEDLINE, Embase, Web of Science, and Cochrane databases to identify articles reporting on LDT with RSA to restore ER. Our primary outcomes were ER, FE, Constant score, and complication incidence. Secondarily, we reported postoperative internal rotation (IR) and compared ER, FE, and Constant score based on lateralized versus medialized global implant design and whether concomitant TMT was performed.Results: Nineteen studies were evaluated; functional outcomes were assessed in 16 articles reporting on 258 RSAs (123 LDT, 135 LDT-TMT). Surgical indication was most commonly cuff tear arthropathy and massive irreparable cuff tear. Mean ER was 212°preoperatively and 25°postoperatively, FE was 72°preoperatively and 141°postoperatively. Mean postoperative Constant score was 65. Of 138 patients (8 studies) describing IR, only 25% reported a mean postoperative IR $L3. Subanalysis comparing lateralized versus medialized implants and whether TMT was concomitantly performed demonstrated no significant difference in postoperative ER, FE, and Constant score, nor preoperative to postoperative improvement in ER and FE. The complication rate was 14.1% (of 291 shoulders from 16 studies), including tear in the tendon transfer (n 5 3), revision tendon repair (n 5 1), nerve-related complication (n 5 9), and dislocation (n 5 9).Conclusions: RSA with LDT is a reliable option to restore motion, with a comparable complication rate with standard RSA. The use of medialized versus lateralized implants and whether the TM was concomitantly transferred may not influence clinical outcomes.Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/A974).

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Section: Discussionmentioning

confidence: 62%

Outcomes of Reverse Total Shoulder Arthroplasty with Latissimus Dorsi Tendon Transfer for External Rotation Deficit

Hones¹,

Rakauskas²,

Wright³

et al. 2023

JBJS Reviews

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A reduced scapulo-humeral angle contributes to the development of scapular notching in reverse total shoulder arthroplasty

Minoli,

Travi,

Compagnoni

et al. 2024

International Orthopaedics (SICOT)

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Purpose Scapular Notching (SN) is one of the most common postoperative complications for a patient after Reverse Total Shoulder Arthroplasty (RTSA). Despite employing various strategies to mitigate SN risk, the overall incidence remains far from zero. This article introduces a new risk factor, the scapulo-humeral angle (SHA), as a key element influencing the risk for SN. Methods A retrospective analysis was conducted on all patients who underwent RTSA for rotator cuff arthropathy at the study centre. The preoperative SHA was measured, and the presence of SN was investigated and graded using the Nerot classification at the latest follow-up. Results 42 patients were included. 12 presented SN (incidence 28.5%). A statistically significant Pearson coefficient correlation between pre-operative SHA and the incidence of SN was observed (r= -0.6954; 95% C.I. -0,8250 to -0,4963; p < 0.0001). A statistically significant Pearson coefficient correlation was also found between the degree of SN and the pre-operative SHA (r= -0,7045; 95% C.I. -0,8306 to -0,5096; P value (two-tailed) < 0,0001, alpha 0.05). Conclusions The primary finding is a statistically significant correlation between a reduced preoperative SHA and an increased incidence of postoperative SN. The secondary finding is that a smaller preoperative SHA is associated with a more severe degree of SN A SHA cut-off of 50° distinguished patients at high risk of SN from those at low risk. All patients with an SHA below 50° developed SN (10/10), whereas only 6.25% of patients with an SHA exceeding 50° experienced SN (2/32).

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Neck shaft angle in reverse shoulder arthroplasty: 135 vs. 145 degrees at minimum 2-year follow-up

Neyton

Nigues

McBride

et al. 2023

Journal of Shoulder and Elbow Surgery

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Does lateralizing the glenosphere center of rotation by 4 mm decrease scapular notching in reverse shoulder arthroplasty with a 135° humeral component?

Cited by 6 publications

References 37 publications

Outcomes of Reverse Total Shoulder Arthroplasty with Latissimus Dorsi Tendon Transfer for External Rotation Deficit

Outcomes of Reverse Total Shoulder Arthroplasty with Latissimus Dorsi Tendon Transfer for External Rotation Deficit

A reduced scapulo-humeral angle contributes to the development of scapular notching in reverse total shoulder arthroplasty

Neck shaft angle in reverse shoulder arthroplasty: 135 vs. 145 degrees at minimum 2-year follow-up

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