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Reverse Total Shoulder Arthroplasty
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The active and passive kinematic difference between primary reverse and total shoulder prostheses.

Tjarco D W Alta1, Joelly M de Toledo2, H E Veeger3

  • 1Department of Orthopaedic Surgery and Traumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands; Amsterdam Rehabilitation Research Center-Reade, Amsterdam, The Netherlands.

Journal of Shoulder and Elbow Surgery
|April 18, 2014
PubMed
Summary

Total shoulder arthroplasty (TSA) offers greater active range of motion than reverse shoulder arthroplasty (RSA), particularly in elevation and abduction. This difference is due to TSA patients fully utilizing prosthetic glenohumeral motion in the scapular plane.

Keywords:
Kinematic analysisactive and passive range of motionglenohumeral motionreverse shoulder arthroplastythoracohumeral motiontotal shoulder arthroplasty

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Area of Science:

  • Orthopedic surgery
  • Biomechanics
  • Arthroplasty

Background:

  • Reverse shoulder arthroplasty (RSA) and total shoulder arthroplasty (TSA) are effective for pain relief and functional improvement.
  • Indications and biomechanical properties differ significantly between RSA and TSA.
  • Understanding kinematic differences is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To analyze active and passive shoulder motion (thoracohumeral [TH], glenohumeral [GH], and scapulothoracic [ST]).
  • To determine kinematic differences in shoulder motion between RSA and TSA patients.
  • To compare the range of motion (ROM) patterns during specific tasks.

Main Methods:

  • Kinematic measurements using a 3D electromagnetic tracking device.
  • Analysis of 16 RSA patients (19 shoulders) and 17 TSA patients (20 shoulders).
  • Evaluation of motion during forward flexion, abduction, and axial rotation tasks.

Main Results:

  • All patients exhibited greater passive than active ROM, with a significantly larger difference in RSA patients.
  • TSA patients demonstrated notably less difference between active and passive ROM in the scapular plane.
  • TSA patients showed significantly greater active TH, GH, and ST motion compared to RSA patients.

Conclusions:

  • TSA facilitates larger active TH motion by enabling full utilization of prosthetic GH motion in the scapular plane.
  • The enhanced active ROM in TSA is specific to elevation and abduction, not axial rotation or passive movements.
  • GH-ST ratios were comparable between RSA and TSA, suggesting prosthesis design influences active motion.