Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
권호 표지
DOI QR코드

DOI QR Code

Radiologic Comparison of Humeral Position according to the Implant Designs Following Reverse Shoulder Arthroplasty: Analysis between Medial Glenoid/Medial Humerus, Lateral Glenoid/Medial Humerus, and Medial Glenoid/Lateral Humerus Designs

  • Cho, Nam Su (Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University) ;
  • Nam, Ju Hyun (Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University) ;
  • Hong, Se Jung (Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University) ;
  • Kim, Tae Wook (Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University) ;
  • Lee, Myeong Gu (Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University) ;
  • Ahn, Jung Tae (Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University) ;
  • Rhee, Yong Girl (Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University)
  • 투고 : 2018.06.10
  • 심사 : 2018.07.30
  • 발행 : 2018.12.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: The currently available reverse shoulder arthroplasty (RSA) designs can be classified into medial glenoid/medial humerus (MGMH), lateral glenoid/medial humerus (LGMH), and medial glenoid/lateral humerus (MGLH) prosthesis designs. The purpose of this study was to radiologically analyze the effect of different RSA designs on humeral position following RSA. Methods: A total of 50 patients who underwent primary RSA were retrospectively analyzed. Among 50 patients, 33 patients (group A: MGMH) underwent RSA with Aequalis system (Wright, Inc, Bloomington, MN, USA), 6 (group B: LGMH) with Aequalis system using bony increased offset, and 11 (group C: MGLH) with Aequalis Ascend Flex system. The acromiohumeral distance, acromioepiphyseal distance (AED), lateral humeral offset (LHO), LHO from the center of rotation ($LHO^{COR}$), and deltoid length were radiologically measured to quantify the distalization and lateralization of the humerus. Results: The increment in postoperative AED was $19.92{\pm}3.93mm$ in group A, $24.52{\pm}5.25mm$ in group B, and $25.97{\pm}5.29mm$ in group C, respectively (p=0.001). The increment in postoperative LHO was $0.13{\pm}6.30mm$, $8.00{\pm}12.14mm$, and $7.42{\pm}6.88mm$, respectively (p=0.005). The increment in postoperative $LHO^{COR}$ was $20.76{\pm}6.06mm$, $22.04{\pm}5.15mm$, and $28.11{\pm}4.14mm$, respectively (p=0.002). Conclusions: The radiologic analysis of the effect of different RSA designs on humeral position following RSA showed significant differences in the increment in postoperative AED, LHO, and $LHO^{COR}$ between the 3 groups. Therefore, MGLH design seems to be more effective for humeral distalization and lateralization compared to original Grammont design.

키워드

GJGJB6_2018_v21n4_192_f0001.png 이미지

A Fig. 1. Preoperative (A) and postoperative (B) acromiohumeral distance (AHD).

GJGJB6_2018_v21n4_192_f0002.png 이미지

A Fig. 2. Preoperative (A) and postoperative (B) acromioepiphyseal distance (AED).

GJGJB6_2018_v21n4_192_f0003.png 이미지

Fig. 3. Preoperative (A) and postoperative (B) lateral humeral offset (LHO). AHD: acromiohumeral distance.

GJGJB6_2018_v21n4_192_f0004.png 이미지

Fig. 4. Preoperative (A) and postoperative (B) lateral humeral offset from the center of rotation (LHOCOR). AHD: acromiohumeral distance.

GJGJB6_2018_v21n4_192_f0005.png 이미지

A Fig. 5. Preoperative (A) and postoperative (B) deltoid length.

Table 1. Group A (MGMH)

GJGJB6_2018_v21n4_192_t0001.png 이미지

Table 2. Group B (LGMH)

GJGJB6_2018_v21n4_192_t0002.png 이미지

Table 3. Group C (MGLH)

GJGJB6_2018_v21n4_192_t0003.png 이미지

Table 4. Preoperative and Postoperative Comparison among Groups A, B, and C

GJGJB6_2018_v21n4_192_t0004.png 이미지

Table 5. Comparison of Differences in Increment among Groups A, B, and C

GJGJB6_2018_v21n4_192_t0005.png 이미지

Table 6. Multiple Comparisons

GJGJB6_2018_v21n4_192_t0006.png 이미지

참고문헌

  1. Wall B, Nove-Josserand L, O'Connor DP, Edwards TB, Walch G. Reverse total shoulder arthroplasty: a review of results according to etiology. J Bone Joint Surg Am. 2007;89(7):1476-85.
  2. Ramirez MA, Ramirez J, Murthi AM. Reverse total shoulder arthroplasty for irreparable rotator cuff tears and cuff tear arthropathy. Clin Sports Med. 2012;31(4):749-59. https://doi.org/10.1016/j.csm.2012.07.009
  3. Boileau P, Watkinson DJ, Hatzidakis AM, Balg F. Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg. 2005;14(1 Suppl S):147S-61S. https://doi.org/10.1016/j.jse.2004.10.006
  4. Boileau P, Gonzalez JF, Chuinard C, Bicknell R, Walch G. Reverse total shoulder arthroplasty after failed rotator cuff surgery. J Shoulder Elbow Surg. 2009;18(4):600-6. https://doi.org/10.1016/j.jse.2009.03.011
  5. Drake GN, O'Connor DP, Edwards TB. Indications for reverse total shoulder arthroplasty in rotator cuff disease. Clin Orthop Relat Res. 2010;468(6):1526-33. https://doi.org/10.1007/s11999-009-1188-9
  6. Melis B, DeFranco M, Ladermann A, et al. An evaluation of the radiological changes around the Grammont reverse geometry shoulder arthroplasty after eight to 12 years. J Bone Joint Surg Br. 2011;93(9):1240-6.
  7. Ladermann A, Edwards TB, Walch G. Arm lengthening after reverse shoulder arthroplasty: a review. Int Orthop. 2014;38(5): 991-1000. https://doi.org/10.1007/s00264-013-2175-z
  8. Ladermann A, Williams MD, Melis B, Hoffmeyer P, Walch G. Objective evaluation of lengthening in reverse shoulder arthroplasty. J Shoulder Elbow Surg. 2009;18(4):588-95. https://doi.org/10.1016/j.jse.2009.03.012
  9. Gutierrez S, Levy JC, Frankle MA, et al. Evaluation of abduction range of motion and avoidance of inferior scapular impingement in a reverse shoulder model. J Shoulder Elbow Surg. 2008;17(4):608-15. https://doi.org/10.1016/j.jse.2007.11.010
  10. Skikumaran U, Salari N, Garzon-Muvdi J, et al. Prosthetic design of reverse total shoulder arthroplasty contributes to scapular notching and instability. Paper presented at: 12th International Congress of Shoulder and Elbow Surgery; 2013 Apr 10- 13; Nagoya, Japan. p.180.
  11. Trouilloud P, Gonzalvez M, Martz P, et al. Duocentric(R) reversed shoulder prosthesis and Personal Fit(R) templates: innovative strategies to optimize prosthesis positioning and prevent scapular notching. Eur J Orthop Surg Traumatol. 2014;24(4): 483-95. https://doi.org/10.1007/s00590-013-1213-2
  12. Boileau P, Moineau G, Roussanne Y, O'Shea K. Bony increased-offset reversed shoulder arthroplasty: minimizing scapular impingement while maximizing glenoid fixation. Clin Orthop Relat Res. 2011;469(9):2558-67. https://doi.org/10.1007/s11999-011-1775-4
  13. Boughebri O, Duparc F, Adam JM, Valenti P. Arthroscopic dynamic analysis of scapular notching in reverse shoulder arthroplasty. Orthop Traumatol Surg Res. 2011;97(8):779-84. https://doi.org/10.1016/j.otsr.2011.07.014
  14. Sadoghi P, Leithner A, Vavken P, et al. Infraglenoidal scapular notching in reverse total shoulder replacement: a prospective series of 60 cases and systematic review of the literature. BMC Musculoskelet Disord. 2011;12:101. https://doi.org/10.1186/1471-2474-12-101
  15. Routman HD, Flurin PH, Wright TW, Zuckerman JD, Hamilton MA, Roche CP. Reverse shoulder arthroplasty prosthesis design classification system. Bull Hosp Jt Dis (2013). 2015;73 Supple 1:S5-14.
  16. Hamilton MA, Roche CP, Diep P, Flurin PH, Routman HD. Effect of prosthesis design on muscle length and moment arms in reverse total shoulder arthroplasty. Bull Hosp Jt Dis (2013). 2013;71 Supple 2:S31-5.
  17. Roche CP, Diep P, Hamilton M, et al. Impact of inferior glenoid tilt, humeral retroversion, bone grafting, and design parameters on muscle length and deltoid wrapping in reverse shoulder arthroplasty. Bull Hosp Jt Dis (2013). 2013;71(4):284-93.
  18. Routman HD. The role of subscapularis repair in reverse total shoulder arthroplasty. Bull Hosp Jt Dis (2013). 2013;71 Suppl 2:108-12.
  19. Valenti P, Sauzieres P, Katz D, Kalouche I, Kilinc AS. Do less medialized reverse shoulder prostheses increase motion and reduce notching? Clin Orthop Relat Res. 2011;469(9):2550-7. https://doi.org/10.1007/s11999-011-1844-8
  20. Middleton C, Uri O, Phillips S, et al. A reverse shoulder arthroplasty with increased offset for the treatment of cuff-deficient shoulders with glenohumeral arthritis. Bone Joint J. 2014;96-B(7): 936-42. https://doi.org/10.1302/0301-620X.96B7.32946
  21. Flatow EL, Harrison AK. A history of reverse total shoulder arthroplasty. Clin Orthop Relat Res. 2011;469(9):2432-9. https://doi.org/10.1007/s11999-010-1733-6
  22. Jazayeri R, Kwon YW. Evolution of the reverse total shoulder prosthesis. Bull NYU Hosp Jt Dis. 2011;69(1):50-5.
  23. Werner BS, Jacquot A, Mole D, Walch G. Is radiographic measurement of acromiohumeral distance on anteroposterior view after reverse shoulder arthroplasty reliable? J Shoulder Elbow Surg. 2016;25(9):e276-80. https://doi.org/10.1016/j.jse.2016.02.017
  24. Renaud P, Wahab H, Bontoux L, Dauty M, Richard I, Bregeon C. [Total inverted shoulder prosthesis and rotator cuff insufficiency: evaluation and determination of anatomical parameters predictive of good functional outcome in 21 shoulders]. Ann Readapt Med Phys. 2001;44(5):273-80. https://doi.org/10.1016/S0168-6054(01)00102-7
  25. Ladermann A, Denard PJ, Boileau P, et al. Effect of humeral stem design on humeral position and range of motion in reverse shoulder arthroplasty. Int Orthop. 2015;39(11):2205-13. https://doi.org/10.1007/s00264-015-2984-3
  26. Jobin CM, Brown GD, Bahu MJ, et al. Reverse total shoulder arthroplasty for cuff tear arthropathy: the clinical effect of deltoid lengthening and center of rotation medialization. J Shoulder Elbow Surg. 2012;21(10):1269-77. https://doi.org/10.1016/j.jse.2011.08.049
  27. De Wilde LF, Audenaert EA, Berghs BM. Shoulder prostheses treating cuff tear arthropathy: a comparative biomechanical study. J Orthop Res. 2004;22(6):1222-30. https://doi.org/10.1016/j.orthres.2004.03.010
  28. Hamilton MA, Diep P, Roche C, et al. Effect of reverse shoulder design philosophy on muscle moment arms. J Orthop Res. 2015;33(4):605-13. https://doi.org/10.1002/jor.22803
  29. Friedman RJ, Flurin PH, Wright TW, Zuckerman JD, Roche CP. Comparison of reverse total shoulder arthroplasty outcomes with and without subscapularis repair. J Shoulder Elbow Surg. 2017;26(4):662-8. https://doi.org/10.1016/j.jse.2016.09.027
  30. Werner BS, Ascione F, Bugelli G, Walch G. Does arm lengthening affect the functional outcome in onlay reverse shoulder arthroplasty? J Shoulder Elbow Surg. 2017;26(12):2152-7. https://doi.org/10.1016/j.jse.2017.05.021

피인용 문헌

  1. Medialized versus Lateralized Center of Rotation in Reverse Total Shoulder Arthroplasty: A Systematic Review and Meta-Analysis vol.10, pp.24, 2018, https://doi.org/10.3390/jcm10245868