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Effect of humeral stem design on humeral position and range of motion in reverse shoulder arthroplasty

Lädermann, Alexandre ; Denard, Patrick ; Boileau, Pascal ; Farron, Alain ; Deransart, Pierric ; Terrier, Alexandre ; Ston, Julien ; Walch, Gilles

In: International Orthopaedics, 2015, vol. 39, no. 11, p. 2205-2213

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    Title
    • Effect of humeral stem design on humeral position and range of motion in reverse shoulder arthroplasty
    Author
    • Lädermann, Alexandre. Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Rue J.-D. Maillard 3, 1217, Meyrin, Switzerland
    • Denard, Patrick. Southern Oregon Orthopedics, Medford, OR, USA
    • Boileau, Pascal. Department of Orthopaedic Surgery and Sports Traumatology, Hôpital de L'Archet-University of Nice Sophia-Antipolis, 151, Route de St Antoine de Ginestière, 06202, Nice, France
    • Farron, Alain. Division of Orthopaedics and Trauma Surgery, Department of Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
    • Deransart, Pierric. Tornier SA, Montbonnot Saint-Martin, France
    • Terrier, Alexandre. Laboratory of Biomechanical Orthopedics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
    • Ston, Julien. Laboratory of Biomechanical Orthopedics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
    • Walch, Gilles. Department of Orthopaedics, Shoulder Unit, Santy Orthopaedic Center and Jean Mermoz Hospital, Lyon, France
    Document Type
    • Postprint
    Language
    • English
    Published in
    • International Orthopaedics, 2015, vol. 39, no. 11, p. 2205-2213. Springer Berlin Heidelberg
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:332963
    Summary
    Purpose: The impacts of humeral offset and stem design after reverse shoulder arthroplasty (RSA) have not been well-studied, particularly with regard to newer stems which have a lower humeral inclination. The purpose of this study was to analyze the effect of different humeral stem designs on range of motion and humeral position following RSA. Methods: Using a three-dimensional computer model of RSA, a traditional inlay Grammont stem was compared to a short curved onlay stem with different inclinations (155°, 145°, 135°) and offset (lateralised vs medialised). Humeral offset, the acromiohumeral distance (AHD), and range of motion were evaluated for each configuration. Results: Altering stem design led to a nearly 7-mm change in humeral offset and 4 mm in the AHD. Different inclinations of the onlay stems had little influence on humeral offset and larger influence on decreasing the AHD. There was a 10° decrease in abduction and a 5° increase in adduction between an inlay Grammont design and an onlay design with the same inclination. Compared to the 155° model, the 135° model improved adduction by 28°, extension by 24° and external rotation of the elbow at the side by 15°, but led to a decrease in abduction of 9°. When the tray was placed medially, on the 145° model, a 9° loss of abduction was observed. Conclusions: With varus inclination prostheses (135° and 145°), elevation remains unchanged, abduction slightly decreases, but a dramatic improvement in adduction, extension and external rotation with the elbow at the side are observed.