Three-dimensional analysis of baseplate screw penetration in reverse total shoulder arthroplasty: risk of iatrogenic suprascapular neuropathy by screw violation
| Autor: | Young Hoon Jang, Sae Hoon Kim, Seung Yeol Oh |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Three dimensional analysis medicine.medical_treatment 3d analysis Bone Screws Iatrogenic Disease Osteoarthritis Suprascapular neuropathy Rotator Cuff Injuries Peripheral Nerve Injuries medicine Humans Orthopedics and Sports Medicine Rotator cuff Retrospective Studies business.industry Shoulder Joint General Medicine Penetration (firestop) equipment and supplies musculoskeletal system medicine.disease Arthroplasty Surgery surgical procedures operative medicine.anatomical_structure Treatment Outcome Arthroplasty Replacement Shoulder Cuff Tear Arthropathy business |
| Zdroj: | Journal of shoulder and elbow surgery. 31(5) |
| ISSN: | 1532-6500 |
| Popis: | Baseplate screws have been suggested to be a possible cause of suprascapular neuropathy after reverse total shoulder arthroplasty (RTSA). Three-dimensional analyses of screw penetration and confirmation of its clinical impacts are relevant. The study aims to investigate the association between screw penetration and the clinical outcomes.Eighty-two patients who underwent RTSA for a massive rotator cuff tear, cuff tear arthropathy, or osteoarthritis with rotator cuff tear were retrospectively enrolled. They were followed up for a minimum of 12 months, and all underwent computed tomography at 1 year postoperatively. The lengths of the superior and posterior baseplate screws were documented. Postoperative computed tomography images were subjected to 3-dimensional analysis to determine whether superior or posterior screws penetrated the glenoid vault and the location to which they penetrated, and screw-to-nerve distances were measured to estimate risks of screw nerve violation and iatrogenic suprascapular neuropathy. Patients with any screw5 mm from the suprascapular nerve were deemed to have a high risk. Clinical outcomes (functional scores, ranges of motion, and isometric strengths) of patients in the high- and lower-risk groups were compared.The mean lengths of the superior and posterior screws were 28 ± 4 mm and 18 ± 3 mm, respectively. Penetration was detected for 13% of superior screws and 64% of posterior screws. Sixty-three percent of penetrating superior screws and 5% of penetrating posterior screws were5 mm from the suprascapular nerve, and therefore, 12% of patients who received RTSA were assessed to have a high risk of iatrogenic suprascapular neuropathy. However, no significant difference was detected in clinical outcomes between the high- and lower-risk patients after a mean follow-up period of 20 months.Twelve percent of patients who received RTSA were assessed to be at high risk of iatrogenic suprascapular neuropathy by baseplate screw penetration. However, the clinical outcomes of RTSA at a minimum follow-up of 1 year were similar in the high- and lower-risk groups. |
| Databáze: | OpenAIRE |
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