International Orthopaedics

, Volume 39, Issue 11, pp 2205–2213 | Cite as

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

  • Alexandre Lädermann
  • Patrick J. Denard
  • Pascal Boileau
  • Alain Farron
  • Pierric Deransart
  • Alexandre Terrier
  • Julien Ston
  • Gilles Walch
Original Paper

Abstract

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.

Keywords

Reverse total shoulder arthroplasty Inlay and onlay design Reverse tray Impingement Humeral offset Arm position Range of motion Complications 

Notes

Conflicts of interest

Two authors (G.W., P.B.) of this study received royalties from Tornier. One author (P.J.D.) is a paid consultant for Arthrex. One author (P.D.) of this study is employee and held stock from Tornier.

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Copyright information

© SICOT aisbl 2015

Authors and Affiliations

  1. 1.Division of Orthopaedics and Trauma SurgeryLa Tour HospitalMeyrinSwitzerland
  2. 2.Faculty of MedicineUniversity of GenevaGeneva 4Switzerland
  3. 3.Division of Orthopaedics and Trauma Surgery, Department of SurgeryGeneva University HospitalsGeneva 14Switzerland
  4. 4.Southern Oregon OrthopedicsMedfordUSA
  5. 5.Department of Orthopaedics and RehabilitationOregon Health & Science UniversityPortlandUSA
  6. 6.Department of Orthopaedic Surgery and Sports TraumatologyHôpital de L’Archet-University of Nice Sophia-AntipolisNiceFrance
  7. 7.Division of Orthopaedics and Trauma Surgery, Department of SurgeryCentre Hospitalier Universitaire VaudoisLausanneSwitzerland
  8. 8.Tornier SAMontbonnot Saint-MartinFrance
  9. 9.Laboratory of Biomechanical OrthopedicsEcole Polytechnique Fédérale de Lausanne (EPFL)LausanneSwitzerland
  10. 10.Department of Orthopaedics, Shoulder UnitSanty Orthopaedic Center and Jean Mermoz HospitalLyonFrance

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