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Assessment of anatomical and reverse total shoulder arthroplasty with the scapula-weighted Constant-Murley score

  • Giovanni Merolla
  • Ilaria Parel
  • Andrea Giovanni Cutti
  • Maria Vittoria Filippi
  • Paolo Paladini
  • Giuseppe Porcellini
Original Paper
  • 8 Downloads

Abstract

Aim of the study

To evaluate total (TSA) and reverse total shoulder arthroplasty (RTSA) using the Constant-Murley score (CMS) and the scapula-weighted (SW) CMS, an integrated outcome measure that takes into account the compensatory movements of the scapula.

Methods

Twenty-five consecutive patients, 12 with TSA and 13 with RTSA, underwent kinematic analysis before and after shoulder replacement. Measurements included flexion (FLEX) and abduction (ABD) for the humerus and Protraction-Retraction (PR-RE), Medio-Lateral rotation (ME-LA), and Posterior-Anterior tilting (P-A) for the scapula. They were recorded at baseline (T0) and at six (T1) and 12 months (T2). Reference data were obtained from 31 control shoulders.

Results

At T1, differences in CMS and SW-CMS were not significant in either group, whereas values at T2 were significantly lower in RTSA patients (p = 0.310 and p = 0.327, respectively). In TSA shoulders, the compensatory scapular movements in FLEX were all reduced from T0 to T2, whereas P-A was increased in ABD. In RTSA patients, the compensatory scapular movements in FLEX showed a general reduction at T1, with an increase in P-A at T2, whereas in ABD, all increased at T1 and decreased at T2 except for P-A, which did not decrease.

Discussion

The SW-CMS showed that the physiological scapulothoracic motion was not restored in TSA and RTSA patients; it may be used as a reference for the gradual progression of deltoid and scapular muscle rehabilitation.

Conclusions

The worse CMS and SW-CMS scores found in RTSA patients at six months may be due to the biomechanics of the reverse prosthesis and to the weakness of deltoid and periscapular muscles.

Keywords

Shoulder osteoarthritis Total arthroplasty Reverse Kinematic analysis Constant-Murley score Scapular dyskines 

Notes

Compliance with ethical standards

IRB approval was obtained from the institutional review board of the Coordinator Center in Cattolica, Italy (Prot. No. 5494/2012 I.5/197 CEAV/IRST Meldola, Italy).

References

  1. 1.
    Roberson TA, Bentley JC, Griscom JT, Kissenberth MJ, Tolan SJ, Hawkins RJ et al (2017) Outcomes of total shoulder arthroplasty in patients younger than 65 year : a systematic review. J Shoulder Elbow Surg 26:1298–1306.  https://doi.org/10.1016/j.jse.2016.12.069 CrossRefPubMedGoogle Scholar
  2. 2.
    Sowa B, Bochenek M, Bülhoff M, Zeifang F, Loew M, Bruckner T et al (2017) The medium- and long-term outcome of total shoulder arthroplasty for primary glenohumeral osteoarthritis in middle-aged patients. Bone Joint J 99-B:939–943.  https://doi.org/10.1302/0301-620X.99B7.BJJ-2016-1365.R1 CrossRefPubMedGoogle Scholar
  3. 3.
    Merolla G, Cerciello S, Marenco S, Fabbri E, Paladini P, Porcellini G (2018) Comparison of shoulder replacement to treat osteoarthritis secondary to instability surgery and primary osteoarthritis: a retrospective controlled study of patient outcomes. Int Orthop 2018. doi:  https://doi.org/10.1007/s00264-018-3969-9
  4. 4.
    Crosby LA, Wright TW, Yu S, Zuckerman JD (2017) Conversion to reverse total shoulder arthroplasty with and without humeral stem retention: the role of a convertible-platform stem. J Bone Joint Surg Am 99:736–742.  https://doi.org/10.2106/JBJS.16.00683 CrossRefPubMedGoogle Scholar
  5. 5.
    Wagner E, Houdek MT, Griffith T, Elhassan BT, Sanchez-Sotelo J, Sperling JW et al (2015) Glenoid bone-grafting in revision to a reverse total shoulder arthroplasty. J Bone Joint Surg Am 97:1653–1660.  https://doi.org/10.2106/JBJS.N.00732 CrossRefPubMedGoogle Scholar
  6. 6.
    Petrillo S, Longo UG, Papalia R, Denaro V (2017) Reverse shoulder arthroplasty for massive irreparable rotator cuff tears and cuff tear arthropathy: a systematic review. Musculoskelet Surg 101:105–112.  https://doi.org/10.1007/s12306-017-0474-z CrossRefPubMedGoogle Scholar
  7. 7.
    Sevivas N, Ferreira N, Andrade R, Moreira P, Portugal R, Alves D et al (2017) Reverse shoulder arthroplasty for irreparable massive rotator cuff tear: a systematic review with meta-analysis and meta-regression. J Shoulder Elbow Surg 26:e265–e277.  https://doi.org/10.1016/j.jse.2017.03.039 CrossRefPubMedGoogle Scholar
  8. 8.
    Zilber S, Camana E, Lapner P, Haritinian E, Nove Josserand L (2018, 2018) Reverse total shoulder arthroplasty using helical blade to optimize glenoid fixation and bone preservation: preliminary results in thirty five patients with minimum two year follow-up. Int Orthop.  https://doi.org/10.1007/s00264-018-3891-1
  9. 9.
    Dauzère F, Arboucalot M, Lebon J, Elia F, Bonnevialle N, Mansat P (2017) Evaluation of thirty eight cemented pegged glenoid components with variable backside curvature: two-year minimum follow-up. Int Orthop 41:2353–2360.  https://doi.org/10.1007/s00264-017-3635-7 CrossRefPubMedGoogle Scholar
  10. 10.
    Lo IKY, Litchfield RB, Griffin S, Faber K, Patterson SDKA (2005) Quality-of-life outcome following hemiarthroplasty or total shoulder arthroplasty in patients with osteoarthritis. a prospective randomized trial. J Bone Joint Surg Am 87-A:2178–2185Google Scholar
  11. 11.
    Sciascia AD, Morris BJ, Jacobs CAET (2017) Responsiveness and internal validity of common patient-reported outcome measures following total shoulder arthroplasty. Orthopedics 40:513–519.  https://doi.org/10.3928/01477447-20170327-02 CrossRefGoogle Scholar
  12. 12.
    Angst F, Schwyzer HS, Aeschlimann A, Simmen BRGJ (2011) Measures of adult shoulder function Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and Its Short Version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society Standardized Shoulder A. Arthritis Care Res 63:S174–S188.  https://doi.org/10.1002/acr.20630 CrossRefGoogle Scholar
  13. 13.
    Constant GC, Emery RJH, SØjbjerg JO, Gohlke F, Boileau P (2008) A review of the Constant score: modifications and guidelines for its use. J Shoulder Elbow Surg 17:355–361.  https://doi.org/10.1016/j.jse.2007.06.022 CrossRefPubMedGoogle Scholar
  14. 14.
    Roy J-S, MacDermid JC, Woodhouse LJ (2010) A systematic review of the psychometric properties of the Constant-Murley score. J Shoulder Elbow Surg 19:157–164.  https://doi.org/10.1016/j.jse.2009.04.008 CrossRefPubMedGoogle Scholar
  15. 15.
    Alta TD, de Toledo JM, Veeger HE, Janssen TW, Willems WJ (2014) The active and passive kinematic difference between primary reverse and total shoulder prostheses. J Shoulder Elbow Surg 23:1395–1402.  https://doi.org/10.1016/j.jse.2014.01.040 CrossRefPubMedGoogle Scholar
  16. 16.
    Kasten P, Maier M, Wendy P, Rettig O, Raiss P, Wolf S et al (2010) Can shoulder arthroplasty restore the range of motion in activities of daily living? A prospective 3D video motion analysis study. J Shoulder Elbow Surg 19:59–65.  https://doi.org/10.1016/j.jse.2009.10.012 CrossRefPubMedGoogle Scholar
  17. 17.
    Kwon YW, Pinto VJ, Yoon J, Frankle MA, Dunning PE, Sheikhzadeh A (2016) Kinematic analysis of dynamic shoulder motion in patients with reverse total shoulder arthroplasty. J Shoulder Elbow Surg 21:1184–1190.  https://doi.org/10.1016/j.jse.2011.07.031 CrossRefGoogle Scholar
  18. 18.
    Maier MW, Caspers M, Zeifang F, Dreher T, Klotz MC, Wolf SI et al (2014) How does reverse shoulder replacement change the range of motion in activities of daily living in patients with cuff tear arthropathy? A prospective optical 3D motion analysis study. Arch Orthop Trauma Surg 134:1065–1071.  https://doi.org/10.1007/s00402-014-2015-7 CrossRefPubMedGoogle Scholar
  19. 19.
    Maier MW, Niklasch M, Dreher T, Zeifang F, Rettig O, Klotz MC et al (2014) Motion patterns in activities of daily living: 3-year longitudinal follow-up after total shoulder arthroplasty using an optical 3D motion analysis system. BMC Musculoskeletal Disorders 15:244.  https://doi.org/10.1186/1471-2474-15-244 CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Postacchini R, Paoloni M, Carbone S, Fini M, Santilli V, Postacchini F et al (2015) Kinematic analysis of reaching movements of the upper limb after total or reverse shoulder arthroplasty. J Biomech 48:3192–3198.  https://doi.org/10.1016/j.jbiomech.2015.07.002 CrossRefPubMedGoogle Scholar
  21. 21.
    Veeger HE, Magermans DJ, Nagels J, Chadwick EK, van der Helm FC (2006) A kinematical analysis of the shoulder after arthroplasty during a hair combing task. Clin Biomech 21:S39–S44.  https://doi.org/10.1016/j.clinbiomech.2005.09.012 CrossRefGoogle Scholar
  22. 22.
    Toledo D, Loss JF, Janssen TW, van der Scheer JW, Alta TD, Willmes WJ et al (2012) Kinematic evaluation of patients with total and reverse shoulder arthroplasty during rehabilitation exercises with different loads. Clin Biomech 21:S39–S44Google Scholar
  23. 23.
    Cutti AG, Parel I, Pellegrini A, Paladini P, Sacchetti R, Porcellini G et al (2016) The Constant score and the assessment of scapula dyskinesis: Proposal and assessment of an integrated outcome measure. J Electromyogr Kinesiol 29:81–89.  https://doi.org/10.1016/j.jelekin.2015.06.011 CrossRefPubMedGoogle Scholar
  24. 24.
    Cutti AG, Parel I, Raggi M, Petracci E, Pellegrini A, Accardo AP et al (2014) Prediction bands and intervals for the scapulo-humeral coordination based on the Bootstrap and two Gaussian methods. J Biomech 47:1035–1044.  https://doi.org/10.1016/j.jbiomech.2013.12.028 CrossRefPubMedGoogle Scholar
  25. 25.
    Michael J, Bercik KK, Yalizis MMG, Chaoui J, Gilles W (2016) A modification to the Walch classification of the glenoid in primary glenohumeral osteoarthritis using three-dimensional imaging. J Shoulder Elbow Surg 25:1601–1606.  https://doi.org/10.1016/j.jse.2016.03.010 CrossRefGoogle Scholar
  26. 26.
    Favard L, Lautmann S, Sirveaux F, Oudet D, Kerjean Y (2001) Hemiarthroplasty versus reverse arthroplasty in the treatment of osteoarthritis with massive rotator cuff tear. In: Walch G, Boileau P, Mole´ D, eds. 2000 Shoulder Prostheses. Two to yen years follow-up. Paris: Sauramps Medical; :261–268Google Scholar
  27. 27.
    Hamada K, Yamanaka K, Uchiyama Y, Mikasa T, Mikasa M (2011) A radiographic classification of massive rotator cuff tear arthritis. Clin Orthop Relat Res 469:2452–2460.  https://doi.org/10.1007/s11999-011-1896-9 CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Merolla G, Ciaramella G, Fabbri E, Walch G, Paladini P, Porcellini G (2016) Total shoulder replacement using a bone ingrowth central peg polyethylene glenoid component: a prospective clinical and computed tomography study with short- to mid-term follow-up. Int Orthop 40:2355–2363.  https://doi.org/10.1007/s00264-016-3255-7 CrossRefPubMedGoogle Scholar
  29. 29.
    Wall B, Nové-Josserand L, O’Connor DP, Edwards TB, Walch G (2007) Reverse total shoulder arthroplasty: a review of results according to etiology. J Bone Joint Surg Am 89:1476–1485.  https://doi.org/10.2106/JBJS.F.00666 PubMedGoogle Scholar
  30. 30.
    Jaspers E, Monari D, Molenaers G, Feys H, Desloovvere K (2014) U.L.E.M.A. - upper limb evaluation in movement analysis: open source custom made MATLAB based software. Gait Posture 39:S76–S77CrossRefGoogle Scholar
  31. 31.
    Wu G, van der Helm FC, Veeger HE, Makhsous M, Van Roy P, Anglin C et al (2005) ISB recommendation on definitions of joint coordinate systems of various joints for the reporting of human joint motion--part II: shoulder, elbow, wrist and hand. J Biomech 38:981–992CrossRefPubMedGoogle Scholar
  32. 32.
    Gamage SS, Lasenby J (2002) New least squares solutions for estimating the average centre of rotation and the axis of rotation. J Biomech 35:87–93CrossRefPubMedGoogle Scholar
  33. 33.
    Kontaxis A, Cutti AG, Johnson GR, Veeger HE (2009) A framework for the definition of standardized protocols for measuring upper-extremity kinematics. Clin Biomech 24:246–253.  https://doi.org/10.1016/j.clinbiomech.2008.12.009 CrossRefGoogle Scholar
  34. 34.
    Torrens C, Guirro P, Santana F (2016) The minimal clinically important difference for function and strength in patients undergoing reverse shoulder arthroplasty. J Shoulder Elbow Surg 25:262–268.  https://doi.org/10.1016/j.jse.2015.07.020 CrossRefPubMedGoogle Scholar
  35. 35.
    Blonna D, Scelsi M, Marini E, Bellato E, Tellini A, Rossi R et al (2012) Can we improve the reliability of the Constant-Murley score? J Shoulder Elbow Surg 21:4–12.  https://doi.org/10.1016/j.jse.2011.07.014 CrossRefPubMedGoogle Scholar
  36. 36.
    Cuomo F, Birdzell MG, Zuckerman JD (2005) The effect of degenerative arthritis and prosthetic arthroplasty on shoulder proprioception. J Shoulder Elbow Surg 14:345–348.  https://doi.org/10.1016/j.jse.2004.07.009 CrossRefPubMedGoogle Scholar
  37. 37.
    Maier MW, Niklasch M, Dreher T, Wolf SI, Zeifabg F, Loew M (2012) Proprioception 3 years after shoulder arthroplasty in 3D motion analysis: a prospective study. Arch Orthop Trauma Surg 132:1003–1010.  https://doi.org/10.1007/s00402-012-1495-6 CrossRefPubMedGoogle Scholar
  38. 38.
    Collin P, Matsukawa T, Denard PJ, Gain S, Läderman A (2017) Pre-operative factors influence the recovery of range of motion following reverse shoulder arthroplasty. Int Orthop 41:2135–2142.  https://doi.org/10.1007/s00264-017-3573-4 CrossRefPubMedGoogle Scholar
  39. 39.
    Wolff AL, Rosenzweig L (2017) Anatomical and biomechanical framework for shoulder arthroplasty rehabilitation. J Hand Ther 30:167–174.  https://doi.org/10.1016/j.jht.2017.05.009 CrossRefPubMedGoogle Scholar
  40. 40.
    Bergmann JH, de Leeuw M, Janssen TW, Weeger DH, Willems WJ (2008) Contribution of the reverse endoprosthesis to glenohumeral kinematics. Clin Orthop Relat Res 466:594–598.  https://doi.org/10.1007/s11999-007-0091-5 CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Lee KW, Kim YI, Kim HY, Yang DS, Lee GS, Choy WS (2016) Three-dimensional scapular kinematics in patients with reverse total shoulder arthroplasty during arm motion. Clin Orthop Surg 8:316–324.  https://doi.org/10.4055/cios.2016.8.3.316 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Giovanni Merolla
    • 1
    • 2
  • Ilaria Parel
    • 2
  • Andrea Giovanni Cutti
    • 3
  • Maria Vittoria Filippi
    • 4
  • Paolo Paladini
    • 1
  • Giuseppe Porcellini
    • 5
  1. 1.Shoulder and Elbow UnitD. Cervesi HospitalCattolicaItaly
  2. 2.“Marco Simoncelli” Biomechanics LaboratoryD. Cervesi Hospital, Cattolica, AUSL della RomagnaAmbito RiminiItaly
  3. 3.INAIL Prostheses CenterVigorso di BudrioItaly
  4. 4.Functional Recovery and Rehabilitation Unit, AUSL della RomagnaAmbito RiminiItaly
  5. 5.Orthopaedic and Trauma Unit, Policlinico di ModenaUniversity of Modena and Reggio EmiliaModenaItaly

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