Functional workspace and patient-reported outcomes improve after reverse and total shoulder arthroplasty

Ngan, Alex; Xiao, Weiyuan; Curran, Patrick F.; Tseng, Wo Jan; Hung, Li-Wei; Nguyen, Chantal; Matthew, Robert Peter; Ma, Benjamin; Lotz, Jeffrey C.

doi:10.1016/j.jse.2019.03.029

Cited by 9 publications

(3 citation statements)

References 21 publications

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“…The adaptation of techniques measuring the functional workspace would therefore provide a more realistic and more reproducible result. 43 In our analysis, we found an improvement of all summarized functional outcome measures in both groups. The scores between both groups did not reach an MCID.…”

Section: Discussionsupporting

confidence: 56%

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Influence of humeral stem inclination in reverse shoulder arthroplasty on range of motion: a meta-analysis

Holsters

Sadeghi

Gendera

et al. 2021

JSES Reviews, Reports, and Techniques

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The reverse shoulder arthroplasty, as introduced by Grammont, has had many modifications over time. One of these modifications was reducing the neck-shaft angle (NSA) from 155 degrees to 135 degrees. Biomechanical studies indicated that lowering the NSA increases external rotation and reduces abduction and the incidence of scapular notching. The purpose of this study was to compare range of motion, functional outcome measures, and complications in patients undergoing reverse shoulder arthroplasty, depending on the NSA, through a systematic review and meta-analysis. Methods: A literature search was conducted (articles published from January 1985 to January 2020) in the PubMed/MEDLINE, Embase, and CINAHL databases and the Cochrane library. All studies reporting outcomes after primary reverse shoulder arthroplasty for osteoarthritis and rotator cufferelated disease were included. Patients were divided into 2 groups: a medialized design (MD) with an NSA of 150-155 degrees and a lateralized design (LD) with an NSA of less than 150 degrees. Pooled effects were calculated in the form of mean differences and 95% confidence intervals (CIs). Risk of bias was assessed using the Risk Of Bias In Non-Randomized Studies -of Interventions tool for non-Randomized Controlled Trials and the Risk Of Bias 2 tool for Randomized Controlled Trials. Results: A total of 21 studies and 3134 arthroplasties were included: 1366 with an MD and 1678 with an LD. The mean age was 73.0 years (MD 74.0 and LD 72.5). A direct comparative meta-analysis was not feasible, and therefore, all data were compared using the minimal clinically important difference. The MD group demonstrated a larger improvement in abduction (56.76 , 95% CI 37.03-76.49) than the LD group (48.52 , 95% CI 28.27-68.78), however the LD group demonstrated a larger improvement in external rotation with the arm at the side (MD: 7.69 , 95% CI 0.01-15.37; LD: 16.14 95% CI 7.18-25.09). When looking at the postoperative range of motion, the MD group had more abduction than the LD group (MD: 136.28 ,). Both designs had a comparable improvement in the Constant Murley score (MD 42.04 points, LD 41.14 points). Lowering the NSA was accompanied by a decrease in dislocation rate (MD: 4.6%; LD: 1.4%; P value .037) and notching rate (MD: 40.3%; LD: 17.3%; P value <.0001). Conclusion:In our analysis, lowering the NSA decreases the amount of abduction but increases the amount of external rotation. This change in range of motion is accompanied by less scapular notching and dislocations. There is no clear impact on functional outcome measures.

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Section: Discussionsupporting

confidence: 56%

“…The adaptation of techniques measuring the functional workspace would therefore provide a more realistic and more reproducible result. 43 …”

Section: Discussionmentioning

confidence: 99%

Influence of humeral stem inclination in reverse shoulder arthroplasty on range of motion: a meta-analysis

Holsters

Sadeghi

Gendera

et al. 2021

JSES Reviews, Reports, and Techniques

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“…These factors have limited the widespread adoption of these technologies in clinical settings and complicated the development of large clinical datasets that will be necessary to estimate population and disease specific distributions. Recent commercially available markerless motion capture (MMC) cameras have been developed that do not require specialized workspaces and equipment, generating a more pragmatic solution for assessment in clinics and other settings [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Point-of-care motion capture and biomechanical assessment improve clinical utility of dynamic balance testing for lower extremity osteoarthritis

et al. 2022

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Musculoskeletal conditions impede patient biomechanical function. However, clinicians rely on subjective functional assessments with poor test characteristics for biomechanical outcomes because more advanced assessments are impractical in the ambulatory care setting. Using markerless motion capture (MMC) in clinic to record time-series joint position data, we implemented a spatiotemporal assessment of patient kinematics during lower extremity functional testing to evaluate whether kinematic models could identify disease states beyond conventional clinical scoring. 213 trials of the star excursion balance test (SEBT) were recorded by 36 subjects during routine ambulatory clinic visits using both MMC technology and conventional clinician scoring. Conventional clinical scoring failed to distinguish patients with symptomatic lower extremity osteoarthritis (OA) from healthy controls in each component of the assessment. However, principal component analysis of shape models generated from MMC recordings revealed significant differences in subject posture between the OA and control cohorts for six of the eight components. Additionally, time-series models of subject posture change over time revealed distinct movement patterns and reduced overall postural change in the OA cohort compared to the controls. Finally, a novel metric quantifying postural control was derived from subject specific kinematic models and was shown to distinguish OA (1.69), asymptomatic postoperative (1.27), and control (1.23) cohorts (p = 0.0025) and to correlate with patient-reported OA symptom severity (R = -0.72, p = 0.018). Time series motion data have superior discriminative validity and clinical utility than conventional functional assessments in the case of the SEBT. Novel spatiotemporal assessment approaches can enable routine in-clinic collection of objective patient-specific biomechanical data for clinical decision-making and monitoring recovery.

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Novel Tools to Approach and Measure Outcomes in Patients with Fractures

Garcia-Lopez,

Halvorson,

Shapiro

2023

Hand Clinics

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Functional workspace and patient-reported outcomes improve after reverse and total shoulder arthroplasty

Cited by 9 publications

References 21 publications

Influence of humeral stem inclination in reverse shoulder arthroplasty on range of motion: a meta-analysis

Influence of humeral stem inclination in reverse shoulder arthroplasty on range of motion: a meta-analysis

Point-of-care motion capture and biomechanical assessment improve clinical utility of dynamic balance testing for lower extremity osteoarthritis

Novel Tools to Approach and Measure Outcomes in Patients with Fractures

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