Document Detail


Humeral component retroversion in reverse total shoulder arthroplasty: a biomechanical study.
MedLine Citation:
PMID:  22036543     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Reverse total shoulder arthroplasty offers pain relief and functional improvement for patients with rotator cuff-deficient shoulders. The purpose of this study was to determine the optimal amount of humeral retroversion for this prosthesis. MATERIALS AND METHODS: Six cadaveric shoulders underwent computed tomography (CT) imaging and were then dissected of soft tissues, except for their tendinous attachments. A reverse total shoulder arthroplasty was implanted in 0°, 20°, 30°, and 40° of retroversion, and the shoulders were mounted on a simulator to determine the muscle forces required to achieve 30° and 60° of scaption. CT images were converted into 3-dimensional models, and the amount of internal and external rotation was determined with computer modeling at various scaption angles. RESULTS: No differences were found in the forces required for 30° or 60° of scaption for any muscle, at any retroversion. With increasing retroversion, more impingement-free external rotation was obtained, with a concomitant decrease in the amount of internal rotation. Above 60°, the humerus was allowed to rotate around the glenosphere unencumbered. CONCLUSIONS: Increasing retroversion did not affect the muscle force requirements for scaption across the shoulder. Placing the humeral component in 0° to 20° of retroversion allows maximum internal rotation with the arm at the side, a movement that is required for daily activities. This limits external rotation with the arm at the side, but has no effect on external rotation with the arm elevated.
Authors:
Lawrence V Gulotta; Dan Choi; Patrick Marinello; Zakary Knutson; Joseph Lipman; Timothy Wright; Frank A Cordasco; Edward V Craig; Russell F Warren
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-29
Journal Detail:
Title:  Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.]     Volume:  -     ISSN:  1532-6500     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206499     Medline TA:  J Shoulder Elbow Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.
Affiliation:
Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA.
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