Haidamous Georges, Lädermann Alexandre, Hartzler Robert U, Parsons Bradford O, Lederman Evan S, Tokish John M, Denard Patrick J
Southern Oregon Orthopedics, Medford, OR, USA.
Division of Orthopedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland.
Shoulder Elbow. 2022 Feb;14(1):39-47. doi: 10.1177/1758573220936234. Epub 2020 Jul 9.
The purpose was to evaluate the relationship of component size and position to postoperative range of motion following reverse shoulder arthroplasty. The hypothesis was that increased lateralization, larger glenospheres, and a decreased acromiohumeral distance would be associated with excellent postoperative range of motion.
A retrospective multicenter study was performed at a minimum of one year postoperatively on 160 patients who underwent primary reverse shoulder arthroplasty with a 135° humeral component. Outcomes were stratified based on postoperative forward flexion and external rotation into excellent ( = 42), defined as forward flexion >140° and external rotation > 30°, or poor ( = 36), defined as forward flexion <100° and external rotation < 15°. Radiographic measurements and component features were compared between the two groups.
A larger glenosphere size was associated with an excellent outcome ( = 0.009). A 2-mm posterior offset humeral cup ( = 0.012) and an increased inferior glenosphere overhang (3.1 mm vs 1.4 mm; = 0.002) were also associated with excellent outcomes. Humeral lateralization and distalization were not associated with an excellent outcome.arger glenosphere size and inferior positioning as well as posterior humeral offset are associated with improved postoperative range of motion following reverse shoulder arthroplasty.
Level 3, retrospective comparative study.
目的是评估反向肩关节置换术后假体组件大小和位置与术后活动范围之间的关系。假设是更大的外展、更大的球窝和减小的肩峰肱骨头距离与良好的术后活动范围相关。
对160例行初次135°肱骨组件反向肩关节置换术的患者进行了一项术后至少一年的回顾性多中心研究。根据术后前屈和外旋情况将结果分为良好（n = 42），定义为前屈>140°且外旋>30°，或较差（n = 36），定义为前屈<100°且外旋<15°。比较两组的影像学测量和假体组件特征。
更大的球窝尺寸与良好的结果相关（P = 0.009）。2mm后倾的肱骨杯（P = 0.012）和更大的球窝下方悬垂（3.1mm对1.4mm；P = 0.002）也与良好的结果相关。肱骨的外展和下移与良好的结果无关。更大的球窝尺寸、更低的位置以及肱骨后倾与反向肩关节置换术后改善的活动范围相关。
3级，回顾性比较研究。
