The influence of humeral neck shaft angle and glenoid lateralization on range of motion in reverse shoulder arthroplasty

Werner, Birgit; Chaoui, Jean; Walch, Gilles

doi:10.1016/j.jse.2017.03.032

Cited by 155 publications

(92 citation statements)

References 18 publications

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“…Previous studies related to ROM of rTSA generally characterize ranges of motions that are contained within a subset of single paths (i.e., abduction, flexion, axial rotation, etc.) . However, conclusions pertaining to implant performance drawn from a subset of investigated motions may be misleading, as it has been shown that differing implant designs maximize different motions .…”

Section: Discussionmentioning

confidence: 99%

“…The most commonly studied ROM‐limiting factor is impingement. Examples of parameters reported to increase impingement‐free ROM include increasing center of rotation lateralization and decreasing humeral cup depth . Some parameters, however, have been reported to have more complicated relationships with ROM, depending on the specific motions studied.…”

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confidence: 99%

“…Some parameters, however, have been reported to have more complicated relationships with ROM, depending on the specific motions studied. For instance, the increasing the neck‐shaft angle has been reported to increase ROM in abduction, but at the cost of decreased impingement‐free ROM in extension, flexion, adduction, and I/E rotation . These complexities in the relationships between implant design and ROM were further highlighted by Virani et al, who reported that maximized impingement‐free abduction, flexion/extension, and I/E rotation motions resulted from implant configurations having variable neck‐shaft angles.…”

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confidence: 99%

“…Examples of parameters reported to increase impingement-free ROM include increasing center of rotation lateralization and decreasing humeral cup depth. [11][12][13][14][15] Some parameters, however, have been reported to have more complicated relationships with ROM, depending on the specific motions studied. For instance, the increasing the neck-shaft angle has been reported to increase ROM in abduction, but at the cost of decreased impingement-free ROM in extension, flexion, adduction, and I/E rotation.…”

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confidence: 99%

“…In addition, current computational models do not consider the effects of multiple motionlimiting factors simultaneously. For example, while increasing the center of rotation lateralization decreases impingement, 1,2,7,11,[13][14][15] it simultaneously increases the required deltoid force. 5,9 So, what is the ultimate effect on the comprehensive ROM?…”

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confidence: 99%

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Development and Application of a Novel Metric to Characterize Comprehensive Range of Motion of Reverse Total Shoulder Arthroplasty

Elwell

Athwal

Willing

2019

Journal Orthopaedic Research

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Active range of motion (ROM) of reverse total shoulder arthroplasty (rTSA) can be limited by bony impingement, muscle inability, and joint instability. The aim of this study was to develop a novel metric representative of comprehensive ROM of rTSA, which is evaluated in the context of all three factors. It was hypothesized that the metric, termed global circumduction ROM (GC‐ROM), would capture differences resulting from directional changes in rTSA design parameters known to increase ROM. GC‐ROM was calculated for a set of 18 rTSA configurations with humeral polyethylene cup depths of 6 and 8.1 mm, glenosphere lateralization (GLat) distances of 0, 5, and 10 mm, and neck‐shaft angles (NSA) of 135°, 145°, and 155°. For any implant configuration, arm positions were defined by internal/external (IE) rotation angle and two spherical coordinates representing the elevation plane angle and elevation angle. At each IE rotation angle, incremental positions with variable elevation plane and elevation angles were checked for feasibility based on impingement, muscle ability, and risk of instability. Coordinates of feasible positions were mapped to unit spheres and connected to form regions, of which the surface area was calculated to represent allowable circumduction ROM. ROMs were averaged across all IE rotation angles to produce a single metric, GC‐ROM. The results showed that decreasing cup depth and increasing GLat and NSA increased GC‐ROM. In conclusion, a novel metric to characterize comprehensive ROM, evaluated based on several ROM‐limiting factors, was developed as a performance metric through which rTSA designs can be compared. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:880‐887, 2020

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