Impact of glenosphere size on clinical outcomes after reverse total shoulder arthroplasty: an analysis of 297 shoulders

Mollon, Brent; Mahure, Siddharth A.; Roche, Christopher P.; Zuckerman, Joseph D.

doi:10.1016/j.jse.2015.10.027

Cited by 74 publications

(47 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…12 The clinical relevance of increasing glenosphere diameter to maximize contact area is conflicting. Mollon et al 16 demonstrated that patients with 42-mm glenospheres had greater improvements in active forward elevation and external rotation compared with patients who had 38-mm glenospheres, whereas Müller et al 17 showed a clinically moderate but significant increase in external rotation strength at midterm follow-up by increasing the glenosphere diameter. In contrast, another study reported that larger glenospheres (42 mm) significantly reduced the development of scapular notching compared with smaller glenospheres (38 mm) without a significant influence in the Constant score.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of Age and Subscapularis Tendon Reparability on Return to Recreational Sports Activities and 2-Year Outcomes After Reverse Total Shoulder Arthroplasty

Godin

Pogorzelski

Horan

et al. 2019

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background:As the indications for reverse total shoulder arthroplasty (RTSA) have continued to expand, the average age of patients undergoing RTSA has decreased.Purpose/Hypothesis:The purpose of this study was to report the minimum 2-year outcomes after RTSA and to evaluate the impact of surgical variables on outcomes. We hypothesized that younger patients, patients with larger glenosphere, and patients with irreparable subscapularis tendons would experience worse subjective patient-reported outcome scores (PROS) and that younger patients and those with a reparable subscapularis would demonstrate a higher rate of return to recreational sports activities.Study Design:Cohort study; Level of evidence, 3.Methods:Patients who underwent RTSA by a single surgeon between November 2005 and September 2014 were considered for this study. Patient characteristics, surgical details, PROS, and rates of return to recreational sports activity were prospectively collected and retrospectively reviewed. We assessed correlations between PROS and both patient age and subscapularis reparability. PROS collected included the American Shoulder and Elbow Surgeons (ASES) score, Short Form 12 (SF-12), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, Single Assessment Numeric Evaluation (SANE), and postoperative patient satisfaction.Results:A total of 110 patients with an average age of 68.0 years (range, 45-87 years) were included. Minimum 2-year follow-up was obtained in 94 patients (85.4%), with a mean follow-up of 3.6 years (range, 2.0-9.3 years). The subscapularis was reparable in 58 patients (57.4%). All PROS significantly improved from pre- to postoperatively (P < .001). The median patient postoperative satisfaction was 9 out of 10 (range, 1-10). Increasing patient age was correlated with significant improvements in QuickDASH and ASES scores. Postoperatively, 76.1% (67/88) of patients were able to return to recreational sports activity. However, of those who did return, 68.2% indicated that they had to modify their activity in some way. Glenosphere size was not significantly associated with PROS or the rate of return to recreational sports activity, but patients with reparable subscapularis tendons demonstrated higher PROS and return to activity rates.Conclusion:Patients who had a reparable subscapularis tendon showed a significantly higher rate of return to recreational sports activity than patients who had a irreparable subscapularis tendon. Older age was correlated with greater improvement in several, although not all, patient-reported outcome measures. Glenosphere size was not significantly associated with higher PROS or rate of return to recreational sports activity.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Other surgical factors that may affect subjective outcomes and return to sporting activity are glenosphere size and subscapularis reparability. 2,3,8,16,22…”

mentioning

confidence: 99%

Impact of Age and Subscapularis Tendon Reparability on Return to Recreational Sports Activities and 2-Year Outcomes After Reverse Total Shoulder Arthroplasty

Godin

Pogorzelski

Horan

et al. 2019

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…Sabesan et al 13 found that glenosphere size did not affect postoperative range of motion or patient satisfaction. Mollon et al 8 reported that patients treated with a larger glenosphere had better postoperative forward elevation and external rotation range of motion. Valenti et al 21 found that less medialization improves rotational range of motion.…”

Section: Discussionmentioning

confidence: 99%

Patient-reported outcomes of reverse total shoulder arthroplasty: a comparative risk factor analysis of improved versus unimproved cases

Parsons

Routman²,

Roche

et al. 2019

JSES Open Access

Self Cite

View full text Add to dashboard Cite

BackgroundThe purpose of this study was to compare characteristics of patients who reported to be subjectively unimproved vs. improved after reverse total shoulder arthroplasty.MethodsData were derived from a prospective registry of patients who underwent reverse total shoulder arthroplasty with a minimum 2-year follow-up. Patients were asked to rate their subjective satisfaction and then divided into those who were unchanged or worse (unimproved group [UG]) vs. better or much better (improved group [IG]). The groups were compared for differences in demographic characteristics, preoperative factors, functional outcomes, and complications.ResultsThere were 1425 patients in the IG and 134 patients in the UG. Patients in the IG were more likely to have a diagnosis of osteoarthritis. Patients in the UG were more likely to have coronary artery disease and diabetes and to have undergone prior surgery. No differences in implant configuration were found between groups. Preoperative measures for patients in the UG were worse for pain and function but not for range of motion. The outcomes in patients in the UG were worse for all postoperative measures, as well as for preoperative-to-postoperative improvement. Of the patients in the UG, 48% continued to have moderate to severe pain postoperatively. The complication rate was significantly higher in the UG.DiscussionUp to 8.5% of patients rate themselves as unimproved after surgery. These patients are more likely to have certain comorbidities and to have undergone prior surgery. Although outcomes were significantly worse for all measures in the UG, improvement occurred in all measures despite patients subjectively being worse or unchanged. Residual pain and difficulty sleeping play a substantial role in subjective assessment of overall outcome.

show abstract

“…Large-diameter glenospheres have been shown to increase stability, provide a greater impingement-free arc of motion, and decrease scapular notching in biomechanical studies [38,49,50]. Mollon et al [51] compared clinical outcomes among a cohort of 297 patients who underwent RTSA with a 38-or 42-mm diameter glenosphere and found that the larger glenospheres increased active forward elevation and external rotation by 15°and 6°, respectively. A recent prospective randomized study of 81 patients also compared 38-to 42-mm diameter glenospheres and noted a statistically significant decrease in scapular notching (48.8% vs. 12.1%) for the larger glenospheres [52•].…”

Section: Glenosphere Sizementioning

confidence: 99%

Reverse Total Shoulder Arthroplasty: Implant Design Considerations

Sheth

Saltzman

2019

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

Purpose of Review Our understanding of the reverse total shoulder arthroplasty (RTSA) has grown exponentially since Grammont first introduced his design in 1985. There are a multitude of implant-related variables to consider when performing RTSA. The purpose of this article is to provide a review of these design considerations. Recent Findings Current literature demonstrates that the traditional Grammont prosthesis has over 90% survivorship at 10 years. Despite these promising results, there have been concerns raised over the significant rate of scapular notching observed. As a result, the traditional RTSA design has been modified to minimize this complication and maximize impingement-free motion. Modern RTSA designs with a cementless, curved, short-stemmed eccentric onlay humeral component combined with a large, lateralized glenosphere placed in 10°of inferior tilt with > 3.5 mm of inferior overhang have been found to provide excellent results. However, all implant design features must be considered on a case-by-case basis to optimize outcome for each patient. Summary Humeral and glenoid implant design variables have evolved as the biomechanics of RTSA have been further elucidated. Consideration of these variables allows the surgeon to maximize joint efficiency, improve impingement-free range of motion, decrease the risk of scapular notching, preserve bone stock, and minimize the risk of instability.

show abstract

Impact of glenosphere size on clinical outcomes after reverse total shoulder arthroplasty: an analysis of 297 shoulders

Cited by 74 publications

References 28 publications

Impact of Age and Subscapularis Tendon Reparability on Return to Recreational Sports Activities and 2-Year Outcomes After Reverse Total Shoulder Arthroplasty

Impact of Age and Subscapularis Tendon Reparability on Return to Recreational Sports Activities and 2-Year Outcomes After Reverse Total Shoulder Arthroplasty

Patient-reported outcomes of reverse total shoulder arthroplasty: a comparative risk factor analysis of improved versus unimproved cases

Reverse Total Shoulder Arthroplasty: Implant Design Considerations

Contact Info

Product

Resources

About