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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
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Predictors of Internal Rotation after Reverse Shoulder Arthroplasty
Joseph T Gibian1, Ruba Sokrab1, Jeffrey R Hill1
1Washington University School of Medicine Department of Orthopaedic Surgery, MO, USA.
The Archives of Bone and Joint Surgery
|December 7, 2023
Summary
Internal rotation after reverse total shoulder arthroplasty (rTSA) is often unpredictable. Higher preoperative internal rotation and improved postoperative forward elevation are key predictors of better outcomes, without compromising other shoulder movements.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Reconstructive Surgery
Background:
- Internal rotation (IR) following reverse total shoulder arthroplasty (rTSA) presents challenges and remains unpredictable.
- Understanding factors influencing post-operative IR is crucial for optimizing patient outcomes.
Purpose of the Study:
- To investigate the relationship between increasing IR and range of motion in other planes after rTSA.
- To identify pre-operative and intra-operative factors associated with improved post-operative IR.
Main Methods:
- Retrospective analysis of 160 primary rTSA cases performed by a single surgeon.
- Data collected included pre-operative and one-year post-operative range of motion, patient demographics, and surgical details (e.g., lesser tuberosity osteotomy).
- Multivariate logistic regression was used to identify independent predictors of sufficient IR.
Main Results:
- Post-operative IR improved significantly from pre-operative levels (20.4% to 32.4%).
- Factors associated with sufficient IR included female sex, lower BMI, higher pre-operative IR, greater pre-operative external rotation, healed lesser tuberosity osteotomy, and improved post-operative forward elevation and external rotation.
- Increased IR did not negatively impact other planes of motion.
Conclusions:
- Internal rotation after rTSA remains modest and unpredictable.
- Higher pre-operative IR and improved one-year post-operative forward elevation are independent predictors of sufficient post-operative IR.
- Achieving adequate IR does not compromise other shoulder movements in this rTSA system.
