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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Influence of arm lengthening in reverse shoulder arthroplasty.
Alexandre Lädermann1, Gilles Walch, Anne Lubbeke
1Service de Chirurgie Orthopédique et Traumatologie de l'Appareil Moteur, Hôpitaux Universitaires de Genève, Geneva, Switzerland. Alexandre.laedermann@hcuge.ch
Journal of Shoulder and Elbow Surgery
|August 6, 2011
Summary
Reverse shoulder arthroplasty (RSA) can improve anterior active elevation (AAE). This study found that arm shortening reduced AAE, while arm lengthening improved it, suggesting deltoid lengthening correlates with functional outcomes.
Area of Science:
- Orthopedic surgery
- Biomechanics
- Rehabilitation
Background:
- Reverse shoulder arthroplasty (RSA) aims to enhance anterior active elevation (AAE) by increasing the deltoid's lever arm.
- Functional outcome variability in RSA necessitates further investigation into range of motion improvements.
Purpose of the Study:
- To correlate humeral and arm lengthening with postoperative anterior active elevation (AAE) following reverse shoulder arthroplasty (RSA).
Main Methods:
- A retrospective review of 183 RSAs with a minimum one-year follow-up was conducted.
- Humeral and arm lengthening were measured relative to the contralateral side.
- Postoperative AAE was recorded and analyzed in relation to measured lengthening or shortening.
Main Results:
- No significant correlation was found between humeral lengthening/shortening and AAE (P = .169).
- Arm shortening resulted in a mean AAE of 122°, while arm lengthening showed improved AAE (140°–147°).
- Significant improvement in AAE was observed with arm lengthening (145°) compared to shortening (122°) (P < .001).
Conclusions:
- Arm shortening negatively impacts AAE after RSA.
- While no specific lengthening threshold was identified, arm lengthening appears beneficial for AAE.
- Objective assessment of deltoid lengthening, measurable pre-, intra-, and postoperatively, correlates with functional outcomes in RSA patients.
