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International Orthopaedics

, Volume 42, Issue 6, pp 1339–1346 | Cite as

What is the best glenoid configuration in onlay reverse shoulder arthroplasty?

  • Alexandre Lädermann
  • Patrick J. Denard
  • Pascal Boileau
  • Alain Farron
  • Pierric Deransart
  • Gilles Walch
Original Paper
  • 335 Downloads

Abstract

Purpose

The purpose of this study was to analyze the effect of different glenoid configurations on arm position and range of motion (ROM) following reverse shoulder arthroplasty (RSA). The hypothesis was that different glenoid configurations would lead to changes in humeral offset, acromio-humeral distance (AHD), ROM, and rotator cuff muscle length.

Methods

Using a three-dimensional (3D) computer model, implantation of an RSA was simulated with a 145° onlay humeral stem combined with five different glenoid configurations which varied in diameter and centre of rotation. Glenoid offset, the AHD, ROM, and muscle length were evaluated for each configuration.

Results

Changing glenoid design led to up to a 10 mm change in offset and a 3 mm change in the AHD. There was 7° of improvement in abduction and flexion between the different glenoid designs. Two of the configurations, the 36 mm centered and the BIO-RSA, had an adduction deficit. In extension and external rotation arm with the arm at side, the eccentric 36 mm glenosphere was the best configuration while the centered 36 mm glenosphere was the worst configuration. The 42 mm glenosphere limited external rotation at 90° of abduction.

Conclusions

Varying the glenosphere configurations leads to ROM and muscle length changes following RSA. With a 145° onlay humeral stem, a 36 eccentric glenosphere theoretically optimizes ROM while limiting scapular notching.

Keywords

Reverse total shoulder arthroplasty Onlay design Glenoid offset Arm position Complications Range of motion Muscle tension 

Notes

Compliance with ethical standards

Conflicts of interest

Two authors (G.W., P.B.) of this study received royalties from the Wright Medical Group NV. One author (P.J.D.) is a paid consultant for Arthrex. One author (P.D.) of this study held stock from the Wright Medical Group NV.

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Copyright information

© SICOT aisbl 2018

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 Rehabilitation, Oregon 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.Imascap SASBrestFrance
  9. 9.Department of Orthopaedics, Shoulder UnitSanty Orthopaedic Center and Jean Mermoz HospitalLyonFrance

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