Posteroinferior glenosphere positioning is associated with improved range of motion following reverse shoulder arthroplasty with a 135° inlay humeral component and lateralized glenoid

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dc.authoridHuffman, G. Russell/0000-0002-2277-5080
dc.authoridKILIC, Ali Ihsan/0000-0001-7491-6044
dc.contributor.authorPak, Theresa
dc.contributor.authorArdebol, Javier
dc.contributor.authorKilic, Ali I.
dc.contributor.authorSears, Benjamin W.
dc.contributor.authorLederman, Evan
dc.contributor.authorWerner, Brian C.
dc.contributor.authorMoroder, Philipp
dc.date.accessioned2025-03-20T09:51:08Z
dc.date.available2025-03-20T09:51:08Z
dc.date.issued2024
dc.departmentİzmir Bakırçay Üniversitesi
dc.description.abstractBackground: Optimal glenosphere positioning in a lateralized reverse shoulder arthroplasty (RSA) to maximize functional outcomes has yet to be clearly defined. Center of rotation (COR) measurements have largely relied on anteroposterior radiographs, which allow assessment of lateralization and inferior position, but ignore scapular Y radiographs, which may provide an assessment of the posterior and inferior position relative to the acromion. The purpose of this study was to evaluate the COR in the sagittal plane and assess the effect of glenosphere positioning with functional outcomes using a 135 degrees degrees inlay stem with a lateralized glenoid. Methods: A retrospective review was performed on a prospectively maintained multicenter database on patients who underwent primary RSA from 2015 to 2021 with a 135 degrees degrees inlay stem. The COR was measured on minimum 2-year postoperative sagittal plain radiographs using a best-fit circle fit method. A best-fit circle was made on the glenosphere and the center was marked. From there, 4 measurements were made: (1) center to the inner cortex of the coracoid, (2) center to the inner cortex of the anterior acromion, (3) center to the inner cortex of the middle acromion, and (4) center to the inner cortex of the posterior acromion. Regression analysis was performed to evaluate any association between the position of the COR relative to bony landmarks with functional outcomes. Results: A total of 136 RSAs met the study criteria. There was no relation with any of the distances with outcome scores (American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, visual analog scale). In regard to range of motion (ROM), each distance had an effect on at least 1 parameter. The COR to coracoid distance had the broadest association with ROM, with improvements in forward flexion (FF), external rotation (ER0), and internal rotation with the arm at 90 degrees (IR90) (P < .001, P = .031, and P < .001, respectively). The COR to coracoid distance was also the only distance to affect the final FF and IR90. For every 1-mm increase in this distance, there was a 1.8 degrees degrees increase in FF and 1.5 degrees increase in IR90 ((3 (3 = 1.78, 95% confidence interval [CI] 0.85-2.72, P < .001, and (3 = 1.53, 95% CI 0.65-2.41, P < .001; respectively). Conclusion: Evaluation of the COR following RSA in the sagittal plane suggests that a posteroinferior glenosphere position may improve ROM when using a 135 degrees degrees inlay humeral component and a lateralized glenoid. Level of evidence: Level IV; Case Series; Treatment Study (c) 2024 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.
dc.description.sponsorshipArthrex, Inc. [AIRR-00608-82]
dc.description.sponsorshipThis study was funded by Arthrex, Inc. (grant AIRR-00608-82)
dc.identifier.doi10.1016/j.jse.2024.02.019
dc.identifier.endpage2177
dc.identifier.issn1058-2746
dc.identifier.issn1532-6500
dc.identifier.issue10
dc.identifier.pmid38537768
dc.identifier.scopus2-s2.0-85195535159
dc.identifier.scopusqualityQ1
dc.identifier.startpage2171
dc.identifier.urihttps://doi.org/10.1016/j.jse.2024.02.019
dc.identifier.urihttps://hdl.handle.net/20.500.14034/2440
dc.identifier.volume33
dc.identifier.wosWOS:001317536700001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherMosby-Elsevier
dc.relation.ispartofJournal of Shoulder and Elbow Surgery
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WOS_20250319
dc.subjectCenter of rotation
dc.subjectreverse shoulder arthroplasty
dc.subjectsagittal radiographs
dc.subjectscapular Y
dc.subjectglenosphere position
dc.subjectoutcomes
dc.titlePosteroinferior glenosphere positioning is associated with improved range of motion following reverse shoulder arthroplasty with a 135° inlay humeral component and lateralized glenoid
dc.typeArticle

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