Lateralized vs. classic Grammont-style reverse shoulder arthroplasty for cuff deficiency Hamada stage 1-3: does the design make a difference?

Freislederer, Florian; Toft, Felix; Audigé, Laurent; Marzel, Alex; Endell, David; Scheibel, Markus

doi:10.1016/j.jse.2021.07.022

Cited by 22 publications

(8 citation statements)

References 44 publications

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“…In a similar study focused on Hamada Grade 1 to 3 cuff-deficient shoulders better external rotation and a trend towards better internal rotation with less scapular notching for lateralized (135° NSA and 4 mm lateralized glenosphere) over non-lateralized RSAs (155° NSA and 2 mm eccentric glenosphere) was reported [ 26 ]. The use of curved stem 145° NSA onlay designs introduced another type of RSA configuration; a computational ROM study for different humeral and glenosphere design concepts showed adequate restoration of glenohumeral ROM only for a lateralized NSA (145°) in combination with eccentric, large or lateralized spheres [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis of three different reverse shoulder arthroplasty designs for cuff tear arthropathy – the combination of lateralization and distalization provides best mobility

Freislederer,

Moroder,

Audigé

et al. 2024

BMC Musculoskelet Disord

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Background The two major reverse shoulder arthroplasty (RSA) designs are the Grammont design and the lateralized design. Even if the lateralized design is biomechanically favored, the classic Grammont prosthesis continues to be used. Functional and subjective patient scores as well as implant survival described in the literature so far are comparable to the lateralized design. A pure comparison of how the RSA design influences outcome in patients has not yet been determined. The aim of this study was a comparison focused on patients with cuff tear arthropathy (CTA). Methods We analyzed registry data from 696 CTA patients prospectively collected between 2012 and 2020 in two specialized orthopedic centers up to 2 years post-RSA with the same follow-up time points (6,12 24 months). Complete teres minor tears were excluded. Three groups were defined: group 1 (inlay, 155° humeral inclination, 36 + 2 mm eccentric glenosphere (n = 50)), group 2 (inlay, 135° humeral inclination, 36 + 4 mm lateralized glenosphere (n = 141)) and group 3 (onlay, 145° humeral inclination, + 3 mm lateralized base plate, 36 + 2 mm eccentric glenosphere (n = 35)) We compared group differences in clinical outcomes (e.g., active and passive range of motion (ROM), abduction strength, Constant-Murley score (CS)), radiographic evaluations of prosthetic position, scapular anatomy and complications using mixed models adjusted for age and sex. Results The final analysis included 226 patients. The overall adjusted p-value of the CS for all time-points showed no significant difference (p = 0.466). Flexion of group 3 (mean, 155° (SD 13)) was higher than flexion of group 1 (mean, 142° (SD 18) and 2 (mean, 132° (SD 18) (p < 0.001). Values for abduction of group 3 (mean, 145° (SD 23)) were bigger than those of group 1 (mean, 130° (SD 22)) and group 2 (mean, 118° (SD 25)) (p < 0.001). Mean external rotation for group 3 (mean, 41° (SD 23)) and group 2 (mean, 38° (SD 17)) was larger than external rotation of group 1 (mean, 24° (SD 16)) (p < 0.001); a greater proportion of group 2 (78%) and 3 (69%) patients reached L3 level on internal rotation compared to group 1 (44%) (p = 0.003). Prosthesis position measurements were similar, but group 3 had significantly less scapular notching (14%) versus 24% (group 2) and 50% (group 1) (p = 0.001). Conclusions Outcome scores of different RSA designs for CTA revealed comparable results. However, CTA patients with a lateralized and distalized RSA configuration were associated with achieving better flexion and abduction with less scapular notching. A better rotation was associated with either of the lateralized RSA designs in comparison with the classic Grammont prosthesis. Level of Evidence Therapeutic study, Level III.

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Section: Discussionmentioning

confidence: 99%

Analysis of three different reverse shoulder arthroplasty designs for cuff tear arthropathy – the combination of lateralization and distalization provides best mobility

Freislederer,

Moroder,

Audigé

et al. 2024

BMC Musculoskelet Disord

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“…Although numerous implant designs with various magnitudes of lateralization have been advocated 2,6-8 , most reports have been case series. According to our review of the literature, there have been 14 studies comparing lateralized RSA with nonlateralized RSA of the equivalent design (Table III) 14,[23][24][25][26][27][28][29][30][31][32][33][34][35] .…”

Section: Discussionmentioning

confidence: 99%

“…Although numerous implant designs with various magnitudes of lateralization have been advocated 2,6-8 , most reports have been case series. According to our review of the literature, there have been 14 studies comparing lateralized RSA with nonlateralized RSA of the equivalent design (Table III) 14,23-35 . Although the scapular notching rate was reduced, most reported no significant differences in range of motion and functional scores between the lateralized RSA and its nonlateralized control (Table III).…”

Section: Discussionmentioning

confidence: 99%

Restoration of External Rotation by Sequential Glenoid Lateralization Based on Body Size in Reverse Shoulder Arthroplasty

Imai

2023

JBJS Open Access

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Background:Although reverse shoulder arthroplasty (RSA) for rotator cuff arthropathy reliably restores anterior elevation (AE), restoration of external rotation (ER) had been unreliable using traditional Grammont-type designs, which has been addressed by lateralizing the center of rotation. This study investigated whether sequential lateralization based on the intraoperatively measured glenoid-humeral axis interval (GHI) results in better outcomes than RSA with a uniform amount of lateralization irrespective of the GHI.Methods:Fifty-four shoulders were treated with a nonlateralized Grammont-type implant between 2016 and 2018 (group A). Forty shoulders were treated with the same Grammont-type implant with 8.0-mm-thick bony increased offset (BIO) between 2014 and 2016 (group B). Fifty consecutive shoulders were treated with a different Grammont-type implant with glenoid-side prosthetic lateralization based on the GHI between 2019 and 2020 (group C). Group C was further stratified into 3 subgroups: group C1 (GHI < 20.0 mm, n = 12) was lateralized by +3.4 mm; C2 (20.0 ≤ GHI ≤ 24.0 mm, n = 25), by +5.4 mm; and C3 (GHI > 24.0 mm, n = 13), by +7.4 mm. Active ER with the arm at the side (ER0) and abducted to 90° (ER90) as well as functional outcomes including active AE and Constant and UCLA scores were evaluated at 2 years postoperatively.Results:The mean age, height, and body mass index and the percentage of male patients were not significantly different between groups A, B, and C. However, the patients in subgroup C1 were the shortest (151.3 ± 3.9 cm) and most elderly (77.5 ± 4.1 years) and had the highest proportion of female patients (91.7%). The patients in subgroup C3 were the tallest (161.1 ± 5.6 cm) and had the highest proportion of male patients (69.2%). ER0, ER90, and the Constant score were significantly larger in group C than in group A. AE, ER0, and the Constant and UCLA scores were significantly larger in group C than in group B.Conclusions:Rather than using a single ideal offset, the optimal lateralization may be better determined according to the body size, the muscle volume, or perhaps the excursion of the musculotendinous unit of each individual patient.Level of Evidence:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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“…Dies zeigt sich ebenfalls in den ersten Studien, die durch eine humerale Verkleinerung des Inklinationswinkels einen signifikanten Rückgang des skapulären Notchings (155°= 66 % versus 135°= 33 %) bestätigten [17,18].…”

Section: Merkeunclassified

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Ameziane,

Imiolczyk,

Steinbeck

et al. 2024

Z Orthop Unfall

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Lateralized vs. classic Grammont-style reverse shoulder arthroplasty for cuff deficiency Hamada stage 1-3: does the design make a difference?

Cited by 22 publications

References 44 publications

Analysis of three different reverse shoulder arthroplasty designs for cuff tear arthropathy – the combination of lateralization and distalization provides best mobility

Analysis of three different reverse shoulder arthroplasty designs for cuff tear arthropathy – the combination of lateralization and distalization provides best mobility

Restoration of External Rotation by Sequential Glenoid Lateralization Based on Body Size in Reverse Shoulder Arthroplasty

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