| Anterior deltoid deficiency in reverse total shoulder replacement: A biomechanical study with cadavers. | |
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MedLine Citation:
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PMID: 23188909 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Reverse total shoulder replacement (RTSR) depends on adequate deltoid function for a successful outcome. However, the anterior deltoid and/or axillary nerve may be damaged due to prior procedures or injury. The purpose of this study was to determine the compensatory muscle forces required for scapular plane elevation following RTSR when the anterior deltoid is deficient. The soft tissues were removed from six cadaver shoulders, except for tendon attachments. After implantation of the RTSR, the shoulders were mounted on a custom-made shoulder simulator to determine the mean force in each muscle required to achieve 30° and 60° of scapular plane elevation. Two conditions were tested: 1) Control with an absent supraspinatus and infraspinatus; and 2) Control with anterior deltoid deficiency. Anterior deltoid deficiency resulted in a mean increase of 195% in subscapularis force at 30° when compared with the control (p = 0.02). At 60°, the subscapularis force increased a mean of 82% (p < 0.001) and the middle deltoid force increased a mean of 26% (p = 0.04). Scapular plane elevation may still be possible following an RTSR in the setting of anterior deltoid deficiency. When the anterior deltoid is deficient, there is a compensatory increase in the force required by the subscapularis and middle deltoid. Attempts to preserve the subscapularis, if present, might maximise post-operative function. |
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Authors:
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L V Gulotta; D Choi; P Marinello; T Wright; F A Cordasco; E V Craig; R F Warren |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of bone and joint surgery. British volume Volume: 94 ISSN: 0301-620X ISO Abbreviation: J Bone Joint Surg Br Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-11-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375355 Medline TA: J Bone Joint Surg Br Country: England |
Other Details:
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Languages: eng Pagination: 1666-9 Citation Subset: AIM; IM |
Affiliation:
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Hospital For Special Surgery, 535 E 70th Street, New York, New York 10021, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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