The effect of lateralization and distalization after Grammont-style reverse total shoulder arthroplasty.

Autor: Clinker C; Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA., Ishikawa H; Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA., Presson AP; Division of Epidemiology, Department of Medicine, University of Utah, Salt Lake City, UT, USA., Zhang C; Division of Epidemiology, Department of Medicine, University of Utah, Salt Lake City, UT, USA., Joyce C; Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA., Chalmers PN; Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA., Tashjian RZ; Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA. Electronic address: Robert.Tashjian@hsc.utah.edu.
Jazyk: angličtina
Zdroj: Journal of shoulder and elbow surgery [J Shoulder Elbow Surg] 2024 Dec; Vol. 33 (12), pp. 2664-2670. Date of Electronic Publication: 2024 May 14.
DOI: 10.1016/j.jse.2024.03.049
Abstrakt: Background: The purpose of this study was to evaluate the relationship between multiple radiographic measures of lateralization and distalization and clinical outcome scores after a reverse total shoulder arthroplasty (RTSA).
Methods: We retrospectively evaluated all RTSAs performed by the senior author between January 1, 2007, and November 1, 2017. We then evaluated the visual analog scale for pain (VAS pain), Simple Shoulder Test (SST), and American Shoulder and Elbow Surgeons (ASES) scores and complication and reoperation rates at a minimum of 2-year follow-up. We measured preoperative and postoperative (2-week) radiographs for the lateralization shoulder angle (LSA), the distalization shoulder angle (DSA), lateral humeral offset, and the distance from the glenoid to the lateral aspect of the greater tuberosity. A multivariable analysis was performed to evaluate the effect of the postoperative radiographic measurements on final patient-reported outcomes (ASES scores, SST, and VAS pain).
Results: The cohort included 216 shoulders from unique patients who had patient-reported outcome scores available at a minimum of 2-year follow-up (average, 4.0 ± 1.9 years) for a total follow-up rate of 70%. In the multivariable models, more lateralization (LSA) was associated with worse final ASES scores -0.52 (95% confidence interval [CI]: -0.88, -0.17; P = .004), and more distalization (DSA) was associated with better final ASES scores 0.40 (95% CI: 0.11, 0.69; P = .007). More lateralization (LSA) was associated with worse final SST scores -0.06 (95% CI: -0.11, -0.003; P = .039). Finally, greater distalization (DSA) was associated with lower final VAS pain scores, ratio = 0.98 (95% CI: 0.96, 1.00; P = .021).
Conclusions: Greater distalization and less lateralization are associated with better function and less pain after a Grammont-style RTSA. When using a Grammont-style implant, remaining consistent with Grammont's principles of implant placement will afford better final clinical outcomes.
(Copyright © 2024 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: