Proprioception in total, hemi- and reverse shoulder arthroplasty in 3D motion analyses: a prospective study

Kasten, Philip; Maier, Michael W.; Rettig, Oliver; Raiss, Patric; Wolf, Sebastian I.; Loew, Markus

doi:10.1007/s00264-008-0666-0

Cited by 36 publications

(50 citation statements)

References 15 publications

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“…Due to this, many groups call for this anatomy to be repaired as precisely as possible when implanting a humeral prosthesis in order to achieve optimal postoperative joint function [1,4,5,7,8,10,13,15,16,18,20,22,23]. Others go further and insist on reconstruction of the centre of rotation specifically [17].…”

Section: Introductionmentioning

confidence: 99%

Differences in reconstruction of the anatomy with modern adjustable compared to second-generation shoulder prosthesis

Irlenbusch

End

Kılıç

2010

International Orthopaedics (SICOT)

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Reconstruction of the anatomy of the proximal humerus is a prerequisite to achieving good long-term clinical results after shoulder arthroplasty. Modern, adjustable prostheses have greater flexibility of inclination, retroversion, and medial and dorsal offset in comparison with older prostheses. Such improvements should allow for better reconstruction of the centre of rotation compared to older prostheses. Reconstruction of the humeral head centre was assessed in 106 modern adjustable (Affinis) and 47 second-generation prostheses. All reconstructions were compared both to the preoperative state and the unoperated shoulder. To describe the pre-and postoperative states, the geometry and position of the humeral head in relation to the glenoid were analysed on patient radiographs. Applying the defined parameters, modern adjustable prostheses showed better reconstruction than second generation prostheses. Parameter values measured in reconstructions using fourth generation prostheses were comparable to those of the unoperated shoulder, but differed significantly from the preoperative state. Second generation prostheses, in contrast, only show non-specific differences in parameter values. This suggests that an approximate reconstruction of normal anatomy can be achieved using a modern fourth generation prosthesis. Reconstruction of the complex anatomy of the proximal humerus is significantly better with modern adjustable prostheses compared to second generation prostheses. Improved clinical outcome can therefore be predicted in a functional and intact rotator cuff. The advantage of using modern prostheses systems over older models is clearly demonstrated in this study. IntroductionThe anatomy of the proximal humerus can vary with respect to inclination, retrotorsion and the medial and dorsal offsets (the offset of the centre of rotation in relation to the humeral axis) [1,6,9,14,17,20,21]. Due to this, many groups call for this anatomy to be repaired as precisely as possible when implanting a humeral prosthesis in order to achieve optimal postoperative joint function [1,4,5,7,8,10,13,15,16,18,20,22,23]. Others go further and insist on reconstruction of the centre of rotation specifically [17].In many cases of osteoarthritis, flattening of the humeral head can be identified (Fig. 1a, b), resulting in conditional lateral displacement of the centre of rotation in relation to shaft axis but causing a medial shift of the of the rotational centre in relation to the glenoid. Other patients show a primary osteoarthritis with no significant deformation of the humeral head (Fig. 1c). The technical demands for reconstruction of the rotational centre differ considerably in both cases.Modern prostheses allow adaptation to both the primary and also pathologically altered secondary anatomy. These prostheses generally allow eccentric adjustment of the prosthesis head in relation to the shaft. Some also feature variable, adjustable inclination.In order to reconstruct a shoulder as closely as possible to the contralateral side...

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Section: Introductionmentioning

confidence: 99%

Differences in reconstruction of the anatomy with modern adjustable compared to second-generation shoulder prosthesis

Irlenbusch

End

Kılıç

2010

International Orthopaedics (SICOT)

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“…Different solutions have been proposed to prevent notching: Frankle et al suggested lateralising the centre of rotation outside the scapula, using an eccentric glenosphere that approaches two thirds of a sphere volume instead the one half used in the original Delta concept, creating more constraint and torque on the glenosphere and increasing the risk of glenoid loosening. Increasing the inclination (neck-shaft angle) of the humeral component will avoid inferior scapular notching [27], but then may create a superior conflict and enhance prosthetic loosening. Baulot and co-workers propose a new glenoid design manufactured by Aston Medical (Duocentric®) with extended inferior coverage that provoked no notching in a case series of 50 patients (unpublished data).…”

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confidence: 99%

Complications with reverse total shoulder arthroplasty and recent evolutions

Scarlat¹

2013

International Orthopaedics (SICOT)

121

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Since its description by Paul Grammont from Dijon, France, several tens of thousands of reverse total shoulder arthroplasties (RTSA) have been performed for diverse conditions. The purpose of this analysis is to identify the complications of this procedure in the literature and in clinical practice. A total of 240 papers concerning RTSA published between 1996 and 2012 have been identified. Over 80 papers describe complications associated with this type of implant. A list of prostheses satisfying European and US standards, CE and FDA approved, has been produced on the basis of information provided by the manufacturers. Data from the literature do not support a meta-analysis. The inventory of best practices shows excellent results in the short and medium term in specific indications, while the number of complications varies between 10 and 65 % in long-term series. Complications can be classified into (A) non-specific including infections (superficial and deep), phlebitis, haematoma, neurological complications of the suprascapular, radial and axillary nerves and (B) specific complications associated with RTSA including (1) on the glenoid side: intraoperative fracture of the glenoid and acromion, late fracture of the scapula, impingement at the scapular neck (notching), glenoid loosening, dissociation of the glenoid component (snatching of the glenosphere) and fractures of the glenoid baseplate; (2) on the humeral side: metaphyseal deterioration, humeral loosening, instability of the shoulder, stiffness with limitation of external and/or internal rotation; and (3) muscular complications with fatty degeneration of the deltoid. Additionally we have identified specific situations related to the type of implant such as the disassembly of the humeral or the glenoid component, dissociation of the polyethylene humeral plate, dissociation of the metaphysis and osteolysis of the tuberosities. The integration of results from different clinical series is difficult because of the lack of a database and the multitude of implants used.

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Section: Proprioception After Shoulder Arthroplastymentioning

confidence: 99%

“…However, to date there are only three studies analyzing proprioception after shoulder replacement [6,12,16]. Two of these studies [6,12] have a short follow-up period, in both cases six months. Cuomo et al [6] performed a passive and guided angle-reproduction test in 20 patients with shoulder osteoarthritis before and six months after total shoulder arthroplasty (TSA) with only one degree of freedom at a time and reported improvement of proprioception [6].…”

Section: Proprioception After Shoulder Arthroplastymentioning

confidence: 99%

“…It is known that joint proprioception plays a considerable role in stabilization of the normal healthy shoulder by helping to control muscular action [1]. However, there is little data available about proprioception of the replaced shoulder before and after surgery [6,12,16]. Parameters routinely examined in previous studies include pain, satisfaction, range of motion, and strength [5].…”

Section: Shoulder Proprioceptionmentioning

confidence: 99%

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