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Int Orthop. 2015 Nov;39(11):2205-13. doi: 10.1007/s00264-015-2984-3. Epub 2015 Sep 18.

Effect of humeral stem design on humeral position and range of motion in reverse shoulder arthroplasty.

Author information

Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Rue J.-D. Maillard 3, 1217, Meyrin, Switzerland.
Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1211, Geneva 4, Switzerland.
Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland.
Southern Oregon Orthopedics, Medford, OR, USA.
Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA.
Department of Orthopaedic Surgery and Sports Traumatology, Hôpital de L'Archet-University of Nice Sophia-Antipolis, 151, Route de St Antoine de Ginestière, 06202, Nice, France.
Division of Orthopaedics and Trauma Surgery, Department of Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Tornier SA, Montbonnot Saint-Martin, France.
Laboratory of Biomechanical Orthopedics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.
Department of Orthopaedics, Shoulder Unit, Santy Orthopaedic Center and Jean Mermoz Hospital, Lyon, France.



The impacts of humeral offset and stem design after reverse shoulder arthroplasty (RSA) have not been well-studied, particularly with regard to newer stems which have a lower humeral inclination. The purpose of this study was to analyze the effect of different humeral stem designs on range of motion and humeral position following RSA.


Using a three-dimensional computer model of RSA, a traditional inlay Grammont stem was compared to a short curved onlay stem with different inclinations (155°, 145°, 135°) and offset (lateralised vs medialised). Humeral offset, the acromiohumeral distance (AHD), and range of motion were evaluated for each configuration.


Altering stem design led to a nearly 7-mm change in humeral offset and 4 mm in the AHD. Different inclinations of the onlay stems had little influence on humeral offset and larger influence on decreasing the AHD. There was a 10° decrease in abduction and a 5° increase in adduction between an inlay Grammont design and an onlay design with the same inclination. Compared to the 155° model, the 135° model improved adduction by 28°, extension by 24° and external rotation of the elbow at the side by 15°, but led to a decrease in abduction of 9°. When the tray was placed medially, on the 145° model, a 9° loss of abduction was observed.


With varus inclination prostheses (135° and 145°), elevation remains unchanged, abduction slightly decreases, but a dramatic improvement in adduction, extension and external rotation with the elbow at the side are observed.


Arm position; Complications; Humeral offset; Impingement; Inlay and onlay design; Range of motion; Reverse total shoulder arthroplasty; Reverse tray

[Indexed for MEDLINE]

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