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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Tracer uptake pattern around the scapula after reverse total shoulder arthroplasty: stress analysis using
Chul-Hyun Cho1, Eun-Seok Son1, Soon Gu Kim2
1Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, South Korea.
Journal of Shoulder and Elbow Surgery
|July 29, 2026
Summary
Reverse total shoulder arthroplasty (rTSA) can cause increased tracer uptake around the scapula, particularly the posterior acromion (PA), indicating stress concentration. SPECT/CT may help detect these stress-related changes in symptomatic patients.
Area of Science:
- Orthopedic surgery
- Radiology
- Medical imaging
Background:
- Reverse total shoulder arthroplasty (rTSA) is a common procedure for complex shoulder conditions.
- Assessing postoperative changes and potential complications around the scapula is crucial for patient outcomes.
Purpose of the Study:
- To investigate tracer uptake patterns on SPECT/CT images around the scapula post-rTSA.
- To correlate these uptake values with clinical parameters.
Main Methods:
- Retrospective review of 35 patients undergoing primary rTSA.
- SPECT/CT imaging performed preoperatively and 6 months postoperatively.
- Measurement of maximum standardized uptake value (SUVmax) at four scapular regions of interest (ROIs).
Main Results:
- Increased postoperative SUVmax observed in the posterior acromion (PA), scapular spine (SS), and coracoid process (CP) compared to preoperative values.
- PA showed the highest mean SUVmax and the largest difference between pre- and postoperative imaging.
- While correlations were observed between SUVmax for PA and clinical parameters (e.g., pain, function), none remained statistically significant after multiple testing correction.
Conclusions:
- SPECT/CT imaging reveals increased tracer uptake in PA, SS, and CP following rTSA, suggesting stress concentration.
- The posterior acromion (PA) is identified as the most vulnerable area for stress concentration after rTSA.
- SPECT/CT may aid in the early detection of stress-related scapular changes in symptomatic patients.
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