Current Concepts of Shoulder Arthroplasty for Radiologists: Part 2???Anatomic and Reverse Total Shoulder Replacement and Nonprosthetic Resurfacing

Ha, Alice S.; Petscavage, Jonelle M.; Chew, Felix S.

doi:10.2214/ajr.12.8855

Cited by 23 publications

(22 citation statements)

References 27 publications

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“…(6) The most commonly encountered complication of anatomic total shoulder arthroplasty is loosening of the glenoid component, which occurs in up to 39% of patients following arthroplasty. (7) Preliminary imaging evaluation of the painful shoulder following an arthroplasty is typically performed using plain radiographs, where glenoid component loosening manifests as glenoid component migration, tilt or periprosthetic radiolucency measuring more than 1.5 mm in thickness. (7,8) The grading of periprosthetic radiolucency for keeled glenoid components was first described by Franklin et al (Table I), (9) and subsequently modified by Lazarus et al to grade periprosthetic radiolucency for pegged glenoid components (Table II).…”

Section: A 2bmentioning

confidence: 99%

“…(7) Preliminary imaging evaluation of the painful shoulder following an arthroplasty is typically performed using plain radiographs, where glenoid component loosening manifests as glenoid component migration, tilt or periprosthetic radiolucency measuring more than 1.5 mm in thickness. (7,8) The grading of periprosthetic radiolucency for keeled glenoid components was first described by Franklin et al (Table I), (9) and subsequently modified by Lazarus et al to grade periprosthetic radiolucency for pegged glenoid components (Table II). (10) Other previously described complications of anatomic total shoulder arthroplasty include loosening of the humeral component (Figs.…”

Section: A 2bmentioning

confidence: 99%

“…(7) In scenarios where plain radiography, ultrasonography or CT fail to identify the underlying cause of the patient's symptoms, magnetic resonance (MR) imaging may be performed to further evaluate for potential pathology or address a specific clinical question. (23) Compared to plain radiography or CT, MR imaging is able to provide a superior assessment of the soft tissue structures surrounding the shoulder joint, which include the rotator cuff, deltoid muscle, neural structures, joint capsule and synovium.…”

Section: A 7bmentioning

confidence: 99%

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Clinics in diagnostic imaging (167)

Tan

Aljefri

Elliott

et al. 2016

smedj

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A 59-year-old woman presented with left shoulder pain and stiffness of 12 months' duration. She had previously undergone an anatomic left total shoulder arthroplasty four years ago for avascular necrosis of the humeral head with advanced secondary glenohumeral osteoarthritis. The patient had actively participated in a postoperative rehabilitation programme, with good pain relief and restoration of function of the left shoulder. However, over a period of 12 months prior to the current clinical presentation, the patient began to experience increasing left shoulder pain and stiffness, which limited her activities of daily living. A physical examination revealed significant reduction in motion of the left shoulder, which included limitation of active forward flexion of about 40°. There was also difficulty in initiating shoulder abduction. Radiographic (Fig. 1a) and arthrographic (Fig. 1b) assessments of the left shoulder were performed. These were followed by dual-energy computed tomography (DECT) of the left shoulder, which was performed without intravenous contrast immediately following the left shoulder arthrogram (Figs. 1c & d).What do these images demonstrate? What is the diagnosis?

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Section: A 2bmentioning

confidence: 99%

Section: A 2bmentioning

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Section: A 7bmentioning

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Clinics in diagnostic imaging (167)

Tan

Aljefri

Elliott

et al. 2016

smedj

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“…Osteoarthritis (OA) of the shoulder is the most frequent indication for total shoulder arthroplasty . The multifactorial etiology of OA is not clearly understood.…”

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“…Osteoarthritis (OA) of the shoulder is the most frequent indication for total shoulder arthroplasty. 1 The multifactorial etiology of OA is not clearly understood. Recent studies suggest that numerous pathways including chronic, mechanical overload can lead to OA.…”

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confidence: 99%

Glenohumeral joint reaction forces increase with critical shoulder angles representative of osteoarthritis—A biomechanical analysis

Viehöfer

Snedeker

Baumgartner

et al. 2016

Journal Orthopaedic Research

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Osteoarthritis (OA) of the glenohumeral joint constitutes the most frequent indication for nontraumatic shoulder joint replacement. Recently, a small critical shoulder angle (CSA) was found to be associated with a high prevalence of OA. This study aims to verify the hypothesis that a small CSA leads to higher glenohumeral joint reaction forces during activities of daily living than a normal CSA. A shoulder simulator with simulated deltoid (DLT), supraspinatus (SSP), infraspinatus/teres minor (ISP/TM), and subscapularis (SSC) musculotendinous units was constructed. The DLT wrapping on the humerus was simulated using a pulley that could be horizontally adjusted to simulate the 28˚CSA found in OA or the 33˚CSA found in disease-free shoulders. Over a range of motion between 6˚and 82˚of thoracohumeral abduction joint forces were measured using a six-axis load cell. An OA-associated CSA yielded higher net joint reaction forces than a normal CSA over the entire range of motion. The maximum difference of 26.4 N (8.5%) was found at 55˚of thoracohumeral abduction. Our model thus suggests that a CSA typical for OA predisposes the glenohumeral joint to higher joint reaction forces and could plausibly play a role in joint overloading and development of OA. Keywords: shoulder; critical shoulder angle; osteoarthritis; biomechanics; etiology Osteoarthritis (OA) of the shoulder is the most frequent indication for total shoulder arthroplasty.1 The multifactorial etiology of OA is not clearly understood. Recent studies suggest that numerous pathways including chronic, mechanical overload can lead to OA.2-4 It has even been suggested that most cases of OA are mechanically induced, 5 although such studies have traditionally investigated the contribution of increased load to the development of OA in the lower extremities and the spine.2,6-9 Nonetheless, it is plausible that aberrant joint loads could also play a role in OA of the glenohumeral joint. For the shoulder, anthropometric differences between patients with OA and a nonarthritic control group have been identified 10,11 : Moor et al. documented that the "critical shoulder angle" (CSA), defined as the angle between a line connecting the inferior margin of the glenoid and the infero-lateral aspect of the acromion and a second line representing the glenoid surface on antero-posterior radiographs, were substantially lower in shoulders with OA than in a study control group.11 The present study sought to investigate the biomechanical consequences of these anatomical differences, and specifically to determine whether the smaller CSA that is typical of arthritic shoulders may predispose increased glenohumeral joint reaction forces and could thereby be a potential factor in mechanical overloading of the joint. METHODSA previously described shoulder simulator was employed to simulate abduction in the scapular plane.12,13 The model consists of a freely hanging dummy humerus with a mass of 3.7 kg (representing a 70 kg human) and a spherical head of radius of 30 mm. The humerus a...

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