Effects of humeral component retroversion on functional outcomes in reverse total shoulder arthroplasty for cuff tear arthropathy

Rhee, Yong Girl; Cho, Nam Su; Moon, Seong Cheol

doi:10.1016/j.jse.2015.03.026

Cited by 70 publications

(49 citation statements)

References 34 publications

(44 reference statements)

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“…A number of studies have attempted to modify the implant design, including those focusing on the lateralized humeral stem or lateralized glenoid baseplate, or change the surgical method, as in humeral component retroversion, to resolve these known issues of limited external and internal rotation. 10,16,30 However, no consensus regarding an effective approach with respect to these issues has been reached. Therefore, more biomechanical and clinical studies that focus on resolving internal rotation deficits will be necessary.…”

Section: Discussionmentioning

confidence: 99%

Difficulty in performing activities of daily living associated with internal rotation after reverse total shoulder arthroplasty

Kim

Jeong

Kim

et al. 2020

Journal of Shoulder and Elbow Surgery

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Section: Discussionmentioning

confidence: 99%

Difficulty in performing activities of daily living associated with internal rotation after reverse total shoulder arthroplasty

Kim

Jeong

Kim

et al. 2020

Journal of Shoulder and Elbow Surgery

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“…Rhee et al 4 reported clinical results from a retrospective single-surgeon series evaluating functional outcomes with 0° and 20° retroversion. At minimum 2-year follow-up for patients undergoing reverse shoulder arthroplasty for rotator cuff arthropathy, no difference was found for external or internal rotation based on humeral retroversion.…”

Section: Discussionmentioning

confidence: 99%

“…A previous clinical study showed decreased ability to perform tasks requiring internal rotation as a result of increased external rotation. 4 For this reason, the current study analyzed specific components of the ASES score that address activities that require internal rotation, namely, the ability to manage toileting and washing the back, to assess for a difference between the groups. All outcome variables underwent statistical analysis with a random effects model to evaluate for statistical significance, with 2-sided alpha of 0.05 and beta of 0.80.…”

Section: Methodsmentioning

confidence: 99%

“…5,6,[9][10][11] The few clinical studies that evaluated the effect of changing the humeral version of these non-Grammont-style humeral components were single-surgeon case series. 4 The current study evaluated 2-year clinical and radiologic outcomes with multiple surgeons to assess whether humeral stem retroversion affects outcomes. The study hypothesis was that greater humeral retroversion (>20°) would increase external rotation and improve clinically validated functional outcome scores or radiographic outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Humeral Component Version on Outcomes in Reverse Shoulder Arthroplasty

Aleem¹,

Feeley²,

Austin³

et al. 2017

Orthopedics

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Although reverse shoulder arthroplasty provides excellent clinical results in appropriately selected patients, loss of external and internal rotation may occur. Component selection, design, and placement affect postoperative results. Recent studies considered the effect of humeral component version on functional results. The current study investigated whether humeral stem retroversion affects the outcomes of reverse shoulder arthroplasty with a retrospective review of a multisurgeon, industry-sponsored, prospectively gathered database of a single reverse shoulder arthroplasty implant. All patients had at least 2-year follow-up. Clinical outcomes, including American Shoulder and Elbow Surgeons score, visual analog scale pain score, Short Form-12 Mental and Physical Component scores, range of motion, and internal rotation function, were compared between patients with humeral retroversion of 10° or less (group A) and those with humeral retroversion of 20° or greater (group B). Radiographic outcomes were compared. The analysis included 64 patients (group A, 29 patients; group B, 35 patients). No clinical or statistically significant difference was found in American Shoulder and Elbow Surgeons scores. Both groups showed statistical and clinical improvement vs preoperative scores, with group A averaging 77.8 and group B averaging 79.2 at final follow-up. No differences were found between groups in range of motion or ability to perform tasks that require shoulder internal rotation. Patients can expect good clinical improvement after reverse shoulder arthroplasty. No difference was found in clinical or radiologic outcomes based on humeral component retroversion. Despite the theoretical increase in external rotation when the humeral component is placed closer to native retroversion, the results did not show this effect. [Orthopedics. 2017; 40(3):179-186.].

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“…The ASES score validity, reliability, and responsiveness has been assessed in a variety of shoulder problems including rotator cuff disease, glenohumeral arthritis, shoulder instability, and shoulder arthroplasty. (41,42) The assessment consists of 11 items, one item for pain and 10 items for function. The score for each subscale is out of 50 (0-50), with a higher score indicating a better outcome.…”

Section: Outcomes {12}mentioning

confidence: 99%

Immediate Accelerated Shoulder Rehabilitation (IASR) vs. Standard Protocol following Reverse Total Shoulder Arthroplasty: A Randomized Controlled Trial.

DeVito

Hatch

Raja

et al. 2020

Preprint

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Background: Recently, the reverse total shoulder arthroplasty (rTSA) became the most frequently performed form of shoulder replacement in the United States and abroad. While physical therapy is universally accepted and routinely practiced, published postoperative rehabilitation guidelines and modifications are based on protocols developed in 1975. Since then, the principle components and temporal concepts of timing and intensity of postoperative rehabilitation and protected immobilization have been controversially applied and expertly discussed without a prevailing consensus. Comparative literature that prospectively addresses treatment differences, influences on outcomes, and superiority or inferiority versus control does not exist. Thus, the objective of this pilot study is to compare an accelerated and immediate active shoulder rehabilitation (IASR) rehabilitation program with standard care in patients following rTSA. Methods:A prospective, randomized, controlled, parallel-designed, two-armed, non-blinded, superiority pilot trial. The comparator arms are an accelerated rehabilitation (IASR) strategy versus standardized care following rTSA (CPT: 23472). The primary outcome measures will be the change from pre-surgical baseline to 52 weeks post-surgery in the American Shoulder and Elbow (ASES) score, Simple Shoulder Test (SST), and global health assessment (PROMIS-10. Secondary and tertiary outcomes will assess subscapularis integrity, implant status, and overall rehabilitation costs compared to formal control. Patients will be recruited from a single site (TRIA Orthopaedic Center, Bloomington, MN) neighboring the fourteenth largest US metropolitan area.Discussion: This trial will be the first study to compare the efficacy and safety of two different postoperative rehabilitation strategies for patients following rTSA. Further, this will be the first study to investigate an accelerated rehabilitation program without a period of protected immobilization following rTSA. Finally, the results will assist in the shared clinical and surgical treatment decisionmaking process.

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Effects of humeral component retroversion on functional outcomes in reverse total shoulder arthroplasty for cuff tear arthropathy

Cited by 70 publications

References 34 publications

Difficulty in performing activities of daily living associated with internal rotation after reverse total shoulder arthroplasty

Difficulty in performing activities of daily living associated with internal rotation after reverse total shoulder arthroplasty

Effect of Humeral Component Version on Outcomes in Reverse Shoulder Arthroplasty

Immediate Accelerated Shoulder Rehabilitation (IASR) vs. Standard Protocol following Reverse Total Shoulder Arthroplasty: A Randomized Controlled Trial.

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