The objective of this study was to compare simulated range of motion (ROM) for reverse total shoulder arthroplasty (rTSA) with and without adjustment for scapulothoracic orientation in a global reference system. We hypothesized that values for simulated ROM in preoperative planning software with and without adjustment for scapulothoracic orientation would be significantly different. A statistical shape model of the entire humerus and scapula was fitted into ten shoulder CT scans randomly selected from 162 patients who underwent rTSA. Six shoulder surgeons independently planned a rTSA in each model using prototype development software with the ability to adjust for scapulothoracic orientation, the starting position of the humerus, as well as kinematic planes in a global reference system simulating previously described posture types A, B, and C. ROM with and without posture adjustment was calculated and compared in all movement planes.Aims
Methods
Both anatomical and reverse total shoulder arthroplasty (aTSA and rTSA) provide functional improvements. A reported benefit of aTSA is better range of motion (ROM). However, it is not clear which procedure provides better outcomes in patients with limited foward elevation (FE). The aim of this study was to compare the outcome of aTSA and rTSA in patients with glenohumeral osteoarthritis (OA), an intact rotator cuff, and limited FE. This was a retrospective review of a single institution’s prospectively collected shoulder arthroplasty database for TSAs undertaken between 2007 and 2020. A total of 344 aTSAs and 163 rTSAs, which were performed in patients with OA and an intact rotator cuff with a minimum follow-up of two years, were included. Using the definition of preoperative stiffness as passive FE ≤ 105°, three cohorts were matched 1:1 by age, sex, and follow-up: stiff aTSAs (85) to non-stiff aTSAs (85); stiff rTSAs (74) to non-stiff rTSAs (74); and stiff rTSAs (64) to stiff aTSAs (64). We the compared ROMs, outcome scores, and complication and revision rates.Aims
Methods
Aims. The aim of this study was to explore why some calcar screws are malpositioned when a proximal humeral fracture is treated by internal fixation with a locking plate, and to identify risk factors for this phenomenon. Some suggestions can be made of ways to avoid this error. Methods. We retrospectively identified all proximal humeral fractures treated in our institution between October 2016 and October 2018 using the hospital information system. The patients’ medical and radiological data were collected, and we divided potential risk factors into two groups: preoperative factors and intraoperative factors. Preoperative factors included age, sex, height, weight, body mass index, proximal humeral bone mineral density, type of fracture, the condition of the medial hinge, and medial metaphyseal head extension. Intraoperative factors included the grade of surgeon,
Objectives. To date, no study has considered the impact of acromial morphology on shoulder range of movement (ROM). The purpose of our study was to evaluate the effects of lateralization of the centre of rotation (COR) and
Controversy about the use of an anatomical total shoulder arthroplasty
(aTSA) in young arthritic patients relates to which is the ideal
form of fixation for the glenoid component: cemented or cementless.
This study aimed to evaluate implant survival of aTSA when used
in patients aged < 60 years with primary glenohumeral osteoarthritis (OA),
and to compare the survival of cemented all-polyethylene and cementless
metal-backed glenoid components. A total of 69 consecutive aTSAs were performed in 67 patients
aged < 60 years with primary glenohumeral OA. Their mean age
at the time of surgery was 54 years (35 to 60). Of these aTSAs,
46 were undertaken using a cemented polyethylene component and 23
were undertaken using a cementless metal-backed component. The age, gender,
preoperative function, mobility, premorbid glenoid erosion, and
length of follow-up were comparable in the two groups. The patients
were reviewed clinically and radiographically at a mean of 10.3
years (5 to 12, Aims
Materials and Methods
This investigation sought to advance the work published in our prior biomechanical study ( A total of 33 adult humeri were used from a previous study where we quantified bone mineral density of the proximal humerus using radiographs and dual-energy x-ray absorptiometry (DEXA), and regional mean cortical thickness and cortical index using radiographs. The bones were fractured in a simulated backwards fall with the humeral head loaded at 2 mm/second via a frustum angled at 30° from the long axis of the bone. Correlations were assessed with ultimate fracture load and these new parameters: cortical index expressed in areas (“areal cortical index”) of larger regions of the diaphysis; the canal-to-calcar ratio used analogous to its application in proximal femurs; and the recently described medial cortical ratio.Objectives
Materials and Methods
The eccentric glenosphere was principally introduced into reverse
shoulder arthroplasty to reduce the incidence of scapular notching.
There is only limited information about the influence of its design
on deltoid power and joint reaction forces. The aim of our study was to investigate how the diameter and
eccentricity of the glenosphere affect the biomechanics of the deltoid
and the resultant joint reaction forces. Different sizes of glenosphere and eccentricity were serially
tested in ten cadaveric shoulders using a custom shoulder movement
simulator.Aims
Methods