Format

Send to

Choose Destination
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

1
Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Rue J.-D. Maillard 3, 1217, Meyrin, Switzerland. alexandre.laedermann@gmail.com.
2
Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1211, Geneva 4, Switzerland. alexandre.laedermann@gmail.com.
3
Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland. alexandre.laedermann@gmail.com.
4
Southern Oregon Orthopedics, Medford, OR, USA.
5
Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA.
6
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.
7
Division of Orthopaedics and Trauma Surgery, Department of Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
8
Tornier SA, Montbonnot Saint-Martin, France.
9
Laboratory of Biomechanical Orthopedics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.
10
Department of Orthopaedics, Shoulder Unit, Santy Orthopaedic Center and Jean Mermoz Hospital, Lyon, France.

Abstract

PURPOSE:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.

KEYWORDS:

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

PMID:
26381907
DOI:
10.1007/s00264-015-2984-3
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center