Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL, USA.
Department Orthopaedic Surgery and Rehabilitation, University of Florida, Gainesville, FL, USA; Department of Anesthesiology, University of Florida, Gainesville, FL, USA.
J Shoulder Elbow Surg. 2020 Feb;29(2):258-265. doi: 10.1016/j.jse.2019.07.003. Epub 2019 Sep 6.
Glenosphere size remains 1 surgeon-controlled variable that can affect patient outcomes following reverse shoulder arthroplasty (RSA). There remains no objective criterion to guide surgeons in choosing glenosphere size. This study's purpose was to evaluate range of motion (ROM) as a function of patient height and glenosphere size to determine the optimal glenosphere size based on patient height.
We retrospectively reviewed 589 primary RSAs from a multicenter shoulder arthroplasty database of a single RSA system with multiple glenosphere sizes. Shoulders were separated into groups based on glenosphere size (38 or 42 mm). Predictive accuracy was calculated in relation to height and sex for predicting glenosphere size. Improvements in active ROM and patient-reported outcome measures (PROMs) were compared based on glenosphere size as a function of height.
Logistic regression analysis demonstrated a strong association of height and sex with surgeon selection of glenosphere size, with shorter heights preferentially treated with 38-mm glenospheres and taller heights with 42-mm glenospheres. There were no statistically significant interaction effects of glenosphere size and height on improvements in ROM or PROMs. These results indicate that for a given glenosphere size, there is not an optimal height range to maximize improvements in postoperative outcome measures.
Height and sex are highly correlated with a surgeon's choice of glenosphere size. However, on the basis of improvements in ROM and PROMs, no recommendation can be made for surgeons to select a particular glenosphere size based on a patient's height. Surgeons should consider other variables when selecting a glenosphere size.
在反肩关节置换术（RSA）后，臼杯尺寸仍然是影响患者预后的一个由外科医生控制的变量。目前还没有客观的标准来指导外科医生选择臼杯尺寸。本研究的目的是评估运动范围（ROM）与患者身高和臼杯尺寸的关系，以确定基于患者身高的最佳臼杯尺寸。
我们回顾性分析了来自一个多中心肩关节置换数据库的 589 例初次 RSA，这些 RSA 均采用单一 RSA 系统和多个臼杯尺寸。根据臼杯尺寸（38 或 42mm）将肩部分为两组。预测准确性与身高和性别相关，用于预测臼杯尺寸。根据身高和性别对 ROM 的主动改善和患者报告的结果测量（PROM）进行比较。
逻辑回归分析表明，身高和性别与外科医生选择臼杯尺寸之间存在很强的关联，身高较矮的患者更倾向于使用 38mm 的臼杯，而身高较高的患者则倾向于使用 42mm 的臼杯。ROM 和 PROM 改善的臼杯尺寸和身高之间没有统计学上显著的交互作用。这些结果表明，对于给定的臼杯尺寸，没有最佳的身高范围可以最大限度地提高术后结果测量的改善。
身高和性别与外科医生选择臼杯尺寸密切相关。然而，根据 ROM 和 PROM 的改善情况，不能建议外科医生根据患者的身高选择特定的臼杯尺寸。外科医生在选择臼杯尺寸时应考虑其他变量。
