Besnard Marion, Samargandi Ramy, Abualross Osamah, Berhouet Julien
Centre Hospitalier Intercommunal d'Amboise, Rue des Ursulines-BP 329, 37403 Amboise Cedex, France.
Department of Orthopedic Surgery, College of Medicine, University of Jeddah, Jeddah 23218, Saudi Arabia.
J Clin Med. 2025 Mar 28;14(7):2324. doi: 10.3390/jcm14072324.
: Reverse shoulder arthroplasty (RSA) improves shoulder function in cases of glenohumeral osteoarthritis and rotator cuff arthropathy. The design of the glenosphere influences mobility and scapular impingement. This study evaluates the impact of joint volume on the range of motion (RoM) and identifies design modifications to enhance mobility while reducing the impingement risk. : Thirty-four cadaveric shoulders were implanted with the Aequalis Reversed II prosthesis in seven configurations: four with 36 mm spheres (centered, 2 mm eccentric, and lateralized by 5 mm and 7 mm) and three with 42 mm spheres (centered, and lateralized by 7 mm and 10 mm). The joint volumes (inferior, anteroinferior, and posteroinferior) were measured via 3D CT scans. The RoM in adduction and elbow-at-side rotations (IR1 and ER1) was recorded. A statistical analysis identified threshold joint volumes correlating with improved mobility. : Larger joint volumes correlated with enhanced mobility. The 42 mm spheres demonstrated better adduction and ER1 compared to those of the 36 mm spheres ( < 0.0001). An inferior volume > 5000 mm and anteroinferior/posteroinferior volumes >2500 mm were thresholds for significant mobility improvement. Lateralization (≥7 mm) or inferior eccentricity (2 mm) improved the mobility with the 36 mm spheres, with the 36 + 2 configuration offering a practical balance for smaller patients. : Increased joint volume enhances mobility, particularly in adduction and elbow-at-side rotations. A sphere with a 2 mm inferior offset or a 42 sphere with 7 mm lateralization optimizes the RoM while minimizing impingement risks. Patient-specific considerations, including anatomy and soft tissue tension, remain essential for optimal prosthesis selection.
反肩置换术（RSA）可改善盂肱关节骨关节炎和肩袖关节病患者的肩部功能。球窝假体的设计会影响活动度和肩胛撞击。本研究评估关节容积对活动范围（RoM）的影响，并确定设计改进方案，以在降低撞击风险的同时增强活动度。：34具尸体肩部以七种配置植入Aequalis Reversed II假体：四种使用36毫米球体（居中、偏心2毫米、向外侧偏移5毫米和7毫米），三种使用42毫米球体（居中、向外侧偏移7毫米和10毫米）。通过三维CT扫描测量关节容积（下方、前下方和后下方）。记录内收和肘部在体侧旋转（IR1和ER1）时的活动范围。统计分析确定了与活动度改善相关的关节容积阈值。：较大的关节容积与增强的活动度相关。与36毫米球体相比，42毫米球体在内收和ER1方面表现更好（<0.0001）。下方容积>5000立方毫米以及前下方/后下方容积>2500立方毫米是活动度显著改善的阈值。对于36毫米球体，向外侧偏移（≥7毫米）或下方偏心（2毫米）可改善活动度，36 + 2配置为体型较小的患者提供了实用的平衡。：增加关节容积可增强活动度，尤其是在内收和肘部在体侧旋转时。具有2毫米下方偏移的球体或向外侧偏移7毫米的42毫米球体可优化活动范围，同时将撞击风险降至最低。包括解剖结构和软组织张力在内的患者个体因素对于选择最佳假体仍然至关重要。
