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Updated: Mar 24, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Ten-Year Outcomes of Modular Reverse Shoulder Arthroplasty Assessed by 3D Motion Analysis
Pit Hetto1, Franz Liewald2, Michael W Maier3
1Department of Orthopedic Surgery, University of Heidelberg, Heidelberg, Germany.
Introduction:
Modular reverse total shoulder arthroplasty (RSA) is a widely accepted treatment for cuff tear arthropathy (CTA), aimed at alleviating pain and improving range of motion (ROM). However, objective long-term data on RSA's impact on activities of daily living (ADL) are sparse. This study is the first to evaluate maximum ROM and ADL performance 10 years after RSA using a 3D motion analysis model.
Materials And Methods:
A case control study with a total of 29 patients with RSA was divided into two groups: 14 patients with an average follow up of 10 years (long-term group) and 15 patients with a follow-up after 6 months (postoperative group). 3D motion analysis was conducted using a Vicon measurement system and HUX shoulder model. Maximum ROM and activity-related ROM (AROM) were assessed during predefined ADLs. Statistical analyses included independent t-tests, calculation of effect sizes (Cohen's d), and adjustment for age and sex using ANCOVA with Bonferroni correction for multiple comparisons.
Results:
At year follow-up, patients demonstrate only slightly lower maximum and activity-related ROM compared to patients 6 months after surgery. Significant differences between the two groups were noted for shoulder flexion during "neck grip" (postoperative 87.7 ± 14.3° vs long-term 70.1 ± 24.3°; Δ = 17.6°, p = 0.016, d = 0.86) and "book" (postoperative 76.5 ± 8.9° vs long-term 67.8 ± 10.7°; Δ = 8.7°, p = 0.017, d = 0.58) as well as internal/external rotation during "armpit washing" (postoperative 27.2 ± 13.0 vs long-term 15.9 ± 7.6°; Δ = 11.3°, p = 0.011, d = 0.64) (p < 0.05), while other movements showed no significant differences.
Discussion:
3D motion analysis revealed comparable maximum ROM and similar range used during ADL following RSA. Long-term deterioration in flexion aligns with previous studies but remains within an acceptable range. The reduced AROM over time may be influenced by natural aging or implant-related factors, though performing ADL was possible.
Conclusion:
Patients after RSA demonstrate good ROM while being able to perform ADL over the long term. With the exceptions of few outcomes, patients 10 years and 6 months after RSA show similar ROM, with good functionality, underscoring the durability and benefits of RSA in managing CTA. Further research with larger cohorts is recommended to confirm these findings.
Level Of Evidence:
Case control study, Level III.
