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Related Concept Videos

Muscles of the Shoulder01:23

Muscles of the Shoulder

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The muscles surrounding the shoulder girdle, including the clavicle and scapula, primarily stabilize the scapula. This stable base allows other muscles to move the humerus effectively. Scapular movements often mirror those of the humerus and extend its range of motion. For instance, raising the arm above the head would not be feasible without simultaneous upward rotation of the scapula.
Anterior Thoracic Muscles
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Nine muscles are involved in arm movements. Two of these, the pectoralis major and latissimus dorsi, originate from the axial skeleton and are called axial muscles. The other seven originate from the scapula and are called the scapular muscles.
The pectoralis major has two origins. Its clavicular head originates on the medial half of the clavicle. In contrast, the sternocostal head originates on the costal cartilages of ribs 1-6, the sternum, and the aponeurosis of the external oblique of the...
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Related Experiment Video

Updated: Aug 4, 2025

Reverse Total Shoulder Arthroplasty
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Subacromial notching after reverse total shoulder arthroplasty.

Hyeon Jang Jeong1, Sang Woo Kim2, Sung-Min Rhee3

  • 1Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

Journal of Shoulder and Elbow Surgery
|April 6, 2023
PubMed
Summary

Subacromial notching (SaN) after reverse total shoulder arthroplasty (RTSA) affects patient outcomes. Risk factors include specific anatomical measurements and implant positioning, necessitating personalized surgical adjustments for better results.

Keywords:
Subacromial notchingdistalization of the implantlateralization of the implantlateralized glenoidlateralized humerus implantreverse total shoulder arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Radiology

Background:

  • Subacromial notching (SaN) is a newly identified complication following reverse total shoulder arthroplasty (RTSA).
  • SaN involves subacromial erosion due to impingement, distinct from scapular notching.
  • This study investigates the clinical incidence and contributing factors of SaN.

Purpose of the Study:

  • To identify risk factors associated with subacromial notching (SaN) after RTSA.
  • To evaluate the impact of SaN on functional outcomes and patient pain levels.
  • To establish clinical guidelines for preventing SaN by considering patient anatomy.

Main Methods:

  • Retrospective review of 125 RTSA patients with at least 2 years follow-up.
  • Radiographic analysis of preoperative and postoperative X-rays to assess anatomical parameters and implant positioning.
  • Evaluation of pain (VAS) and functional scores (ASESS) to determine SaN's clinical effect.

Main Results:

  • SaN occurred in 12.8% of patients.
  • Preoperative center of rotation-acromion distance (<14.0 mm) and postoperative humerus lateralization (<19.0 mm) were significant risk factors.
  • Patients with SaN reported worse pain and ASESS scores postoperatively.

Conclusions:

  • Subacromial notching (SaN) negatively impacts clinical outcomes after RTSA.
  • Patient's native anatomy and surgical lateralization degree are key factors in SaN development.
  • Tailoring implant lateralization to individual anatomy is crucial for mitigating SaN risk.