No difference in range of motion in reverse total shoulder arthroplasty using standard or constrained liners : a matched cohort study

© 2022 The Author(s).

Bibliographische Detailangaben
Veröffentlicht in:JSES international. - 2020. - 6(2022), 6 vom: 25. Nov., Seite 929-934
1. Verfasser: Goodloe, J Brett (VerfasserIn)
Weitere Verfasser: Denard, Patrick J, Lederman, Evan, Gobezie, Reuben, Werner, Brian C
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2022
Zugriff auf das übergeordnete Werk:JSES international
Schlagworte:Journal Article Constrained Glenohumeral arthritis Instability Outcomes Reverse shoulder arthroplasty Shoulder motion
Beschreibung
Zusammenfassung:© 2022 The Author(s).
Background: Prosthetic instability is one of the most common short-term complications following reverse total shoulder arthroplasty (RTSA). Numerous strategies exist to attempt to mitigate this complication, including utilization of constrained polyethylene humeral liners. A concern of constrained humeral liners is that they may come at the expense of restricted rotational range of motion (ROM). The purpose of the present study is to compare range of ROM and patient-reported outcomes (PROs), and satisfaction among matched cohorts using constrained vs. unconstrained liners after RTSA
Methods: A multicenter shoulder arthroplasty registry was retrospectively reviewed to identify patients with two-year clinical follow-up after RTSA with constrained liners used at the surgeon's discretion. All patients had the same inlay humeral prosthesis with a 135° neck shaft angle. This study cohort was matched 1:2 to control patients who underwent RTSA with standard liners based on age, sex, total glenoid-sided lateralization, glenosphere diameter, and surgery performed on the dominant arm. Improvement in PROs and ROM was compared between groups
Results: Twenty-two patients were identified who underwent RTSA with a constrained humeral liner; these were compared to 44 matched patients with standard liners. The groups were found to have no notable differences in demographics, baseline PROs and ROM. At two years postoperatively, both cohorts demonstrated improvements in all PROs without statistically significant differences between the two groups. There were no differences between groups in improvement in any ROM measure, including forward flexion (constrained: 54°, standard: 57°, P = .771), external rotation at the side (constrained: 42°, standard: 41°, P = .906) or internal rotation at 90° of abduction (constrained: 24°, standard: 20°, P = .587)
Conclusions: For an inlay humeral prosthesis with a 135° neck shaft angle, utilization of a constrained liner for RTSA demonstrates no significant difference in ROM or PROs compared to a well-matched cohort of patients who underwent RTSA with a standard polyethylene humeral liner. These are reassuring data for using constrained liners when there is intraoperative concern for prosthetic instability
Beschreibung:Date Revised 11.11.2022
published: Electronic-eCollection
Citation Status PubMed-not-MEDLINE
ISSN:2666-6383
DOI:10.1016/j.jseint.2022.07.004