Effect of humeral component version on impingement in reverse total shoulder arthroplasty
| Autor: | Daniel R. Stephenson, Joo Han Oh, Thay Q. Lee, George F. Rick Hatch, Michelle H. McGarry |
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| Rok vydání: | 2010 |
| Předmět: |
musculoskeletal diseases
Male Shoulder surgery Rotation medicine.medical_treatment Joint Prosthesis Deltoid curve Prosthesis Postoperative Complications Scapula Materials Testing Medicine Humans Orthopedics and Sports Medicine Arthroplasty Replacement Range of Motion Articular Aged Subluxation Aged 80 and over business.industry Shoulder Joint General Medicine Anatomy Humerus Middle Aged Shoulder Prosthesis medicine.disease Arthroplasty Shoulder Impingement Syndrome Surgery Female Stress Mechanical business Range of motion |
| Zdroj: | Journal of shoulder and elbow surgery. 20(4) |
| ISSN: | 1532-6500 |
| Popis: | Reverse shoulder arthroplasty is growing in popularity for patients with deficient rotator cuffs; however, the phenomenon of scapular notching continues to be a concern. This study examined the effects of humeral component version in the Aequalis Reversed Shoulder Prosthesis (Tornier, Edina, MN) on impingement of the humeral prosthesis against the scapula to test the hypothesis that the mechanical contact of the humeral component with the scapular neck is influenced by the version of the humeral component.Seven shoulders from deceased donors were tested after the Aequalis Reversed Shoulder was implanted. The deltoid, pectoralis major, and latissimus dorsi were loaded based on physiologic cross-sectional area. The degree of internal and external rotation when impingement, subluxation, or dislocation occurred was measured at 0°, 30°, and 60° glenohumeral abduction in the scapular plane. Testing was performed with the humeral component placed in 20° of anteversion, neutral version, 20° of retroversion, and 40° of retroversion.Maximum external rotation at 0° abduction was -1° ± 4° at 20° anteversion, 15° ± 3° at neutral, 28° ± 4° at 20° retroversion, and 44° ± 5° at 40° retroversion (P.05). Maximum internal rotation at 0° abduction was 128° ± 9° at 20° anteversion, 112° ± 9° at neutral, 99° ± 8° at 20° retroversion, and 83° ± 8° at 40° retroversion (P.05). Maximum external rotation at 30° abduction was 70° ± 6° at 20° anteversion, 84° ± 7° at neutral, 97° ± 6° at 20° retroversion, and 110° ± 5° at 40° retroversion (P.05). There was no limitation to internal rotation at 30° abduction. No impingement occurred at 60° abduction.Version of the humeral component plays a role in range of motion and impingement in reverse total shoulder arthroplasty. Anteversion can significantly decrease the amount of external rotation achievable after reverse total shoulder surgery.Placing the Aequalis Reversed Shoulder humeral component at between 20° and 40° of retroversion more closely restores a functional arc of motion without impingement. |
| Databáze: | OpenAIRE |
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