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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

Abstract

Background

Reverse total shoulder arthroplasty (RSA) can improve function in cuff tear arthropathy (CTA) shoulders, but limited exact data are available about the maximum values in 3D motion analysis, and as to how improvements translate into the normal range of motion (ROM) in activities of daily living (ADLs).

Methods

This study included nine consecutive patients (n = 9) who received RSA for CTA without muscle transfers. We measured shoulder movement by a novel 3D motion analysis using the Heidelberg upper extremity model (HUX) which can eliminate compensatory movements of the scapula, and the trunk. The measurement included active maximum values, and four ADLs.

Results

Comparing the pre- to the 1-year postoperative status, RSA was associated with a significant increase in the mean maximum values for active flexion of about 43° (SD ± 31) from 66° to 109° (p = 0.001), for active abduction of about 37° (SD ± 26) from 57° to 94° (p = 0.001), and for the active adduction of about 28° (SD ± 10) from 5° to 33° (p = 0.002). Comparing the preoperative to the postoperative ROM in the ADLs in flexion/extension, ROM improved significantly in all ADLs, in abduction/adduction in three of four ADLs. No significant changes were observed in internal/external rotation in any ADLs.

Conclusion

RSA improves the active maximum ROM for flexion, abduction, and adduction. The patients are able to take advantage of this ROM increase in ADLs in flexion and in most ADL in abduction, but only in trend in internal and external rotation.

Level of evidence

Level IV, Case Series with no comparison group.

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References

  1. Neer CS, Craig EV, Fukuda H (1983) Cuff-tear arthropathy. J Bone Jt Surg Am 65(9):1232–1244

    Google Scholar 

  2. Cil A et al (2010) Survivorship of the humeral component in shoulder arthroplasty. J Shoulder Elb Surg 19(1):143–150

    Article  Google Scholar 

  3. Grammont PM, Baulot E (1993) Delta shoulder prosthesis for rotator cuff rupture. Orthopedics 16(1):65–68

    CAS  PubMed  Google Scholar 

  4. Ladermann A et al (2009) Objective evaluation of lengthening in reverse shoulder arthroplasty. J Shoulder Elb Surg 18(4):588–595

    Article  Google Scholar 

  5. Kwon YW et al (2012) Kinematic analysis of dynamic shoulder motion in patients with reverse total shoulder arthroplasty. J Shoulder Elb Surg 21(9):1184–1190

    Article  Google Scholar 

  6. Boileau P et al (2006) Neer award 2005: the Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J Shoulder Elb Surg 15(5):527–540

    Article  Google Scholar 

  7. Frankle M et al (2005) The Reverse shoulder prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency. A minimum two-year follow-up study of sixty patients. J Bone Jt Surg Am 87(8):1697–1705

    Article  Google Scholar 

  8. Guery J et al (2006) Reverse total shoulder arthroplasty. Survivorship analysis of eighty replacements followed for five to ten years. J Bone Jt Surg Am 88(8):1742–1747

    Article  Google Scholar 

  9. Sirveaux F et al (2004) Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Jt Surg Br 86(3):388–395

    Article  CAS  Google Scholar 

  10. Werner CM et al (2005) Treatment of painful pseudoparesis due to irreparable rotator cuff dysfunction with the delta III reverse-ball-and-socket total shoulder prosthesis. J Bone Jt Surg Am 87(7):1476–1486

    Article  CAS  Google Scholar 

  11. Constant CR (1997) An evaluation of the Constant-Murley shoulder assessment. J Bone Jt Surg Br 79(4):695–696

    CAS  Google Scholar 

  12. Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164

    PubMed  Google Scholar 

  13. Rettig O et al (2009) A new kinematic model of the upper extremity based on functional joint parameter determination for shoulder and elbow. Gait Posture 30(4):469–476

    Article  PubMed  Google Scholar 

  14. Germann G, Wind G, Harth A (1999) The DASH (disability of arm-shoulder-hand) questionnaire—a new instrument for evaluating upper extremity treatment outcome. Handchir Mikrochir Plast Chir 31(3):149–152

    Article  CAS  PubMed  Google Scholar 

  15. Offenbacher M et al (2003) Validation of a German version of the ‘Disabilities of Arm, Shoulder and Hand’ questionnaire (DASH-G). Z Rheumatol 62(2):168–177

    Article  CAS  PubMed  Google Scholar 

  16. Hamada K et al (1990) Roentgenographic findings in massive rotator cuff tears. A long-term observation. Clin Orthop Relat Res 254:92–96

    PubMed  Google Scholar 

  17. Fuchs B et al (2006) Clinical and structural results of open repair of an isolated one-tendon tear of the rotator cuff. J Bone Jt Surg Am 88(2):309–316

    Article  Google Scholar 

  18. Goutallier D et al (1994) Fatty muscle degeneration in cuff ruptures. Pre- and post-operative evaluation by CT scan. Clin Orthop Relat Res 304:78–83

    PubMed  Google Scholar 

  19. Simovitch RW et al (2007) Impact of fatty infiltration of the teres minor muscle on the outcome of reverse total shoulder arthroplasty. J Bone Jt Surg Am 89(5):934–939

    Article  Google Scholar 

  20. Neer CS, Watson KC, Stanton FJ (1982) Recent experience in total shoulder replacement. J Bone Jt Surg Am 64(3):319–337

    Google Scholar 

  21. Veeger HE et al (2006) A kinematical analysis of the shoulder after arthroplasty during a hair combing task. Clin Biomech (Bristol, Avon) 21(Suppl 1):S39–S44

    Article  Google Scholar 

  22. Rab G, Petuskey K, Bagley A (2002) A method for determination of upper extremity kinematics. Gait Posture 15(2):113–119

    Article  PubMed  Google Scholar 

  23. Wu G 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(5):981–992

    Article  CAS  PubMed  Google Scholar 

  24. Carman AB, Milburn PD (2006) Determining rigid body transformation parameters from ill-conditioned spatial marker co-ordinates. J Biomech 39(10):1778–1786

    Article  CAS  PubMed  Google Scholar 

  25. Chiari L et al (2005) Human movement analysis using stereophotogrammetry. Part 2: instrumental errors. Gait Posture 21(2):197–211

    Article  PubMed  Google Scholar 

  26. Doorenbosch CA, Harlaar J, Veeger DH (2003) The globe system: an unambiguous description of shoulder positions in daily life movements. J Rehabil Res Dev 40(2):147–155

    Article  PubMed  Google Scholar 

  27. Alta TD et al (2011) Kinematic and clinical evaluation of shoulder function after primary and revision reverse shoulder prostheses. J Shoulder Elb Surg 20(4):564–570

    Article  Google Scholar 

  28. Henninger HB et al (2012) Effect of deltoid tension and humeral version in reverse total shoulder arthroplasty: a biomechanical study. J Shoulder Elb Surg 21(4):483–490

    Article  Google Scholar 

  29. Boileau P et al (2005) Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elb Surg 14(1 Suppl S):147S–161S

    Article  Google Scholar 

  30. Henninger HB et al (2012) Effect of lateral offset center of rotation in reverse total shoulder arthroplasty: a biomechanical study. J Shoulder Elb Surg 21(9):1128–1135

    Article  Google Scholar 

  31. Cuff D et al (2008) Reverse shoulder arthroplasty for the treatment of rotator cuff deficiency. J Bone Jt Surg Am 90(6):1244–1251

    Article  Google Scholar 

  32. Rettig O et al (2013) Does the reverse shoulder prosthesis medialize the center of rotation in the glenohumeral joint? Gait Posture 37(1):29–31

    Article  PubMed  Google Scholar 

  33. Maier MW et al (2012) Proprioception 3 years after shoulder arthroplasty in 3D motion analysis: a prospective study. Arch Orthop Trauma Surg 132(7):1003–1010

    Article  PubMed  Google Scholar 

  34. Maier MW et al (2014) 3D motion capture using the HUX model for monitoring functional changes with arthroplasty in patients with degenerative osteoarthritis. Gait Posture 39(1):7–11

    Article  PubMed  Google Scholar 

  35. Boileau P et al (2008) Reverse shoulder arthroplasty combined with a modified latissimus dorsi and teres major tendon transfer for shoulder pseudoparalysis associated with dropping arm. Clin Orthop Relat Res 466(3):584–593

    Article  PubMed Central  PubMed  Google Scholar 

  36. Jobin CM et al (2012) Reverse total shoulder arthroplasty for cuff tear arthropathy: the clinical effect of deltoid lengthening and center of rotation medialization. J Shoulder Elb Surg 21(10):1269–1277

    Article  Google Scholar 

  37. Lawrence TM et al (2012) Patient reported activities after reverse shoulder arthroplasty: part II. J Shoulder Elb Surg 21(11):1464–1469

    Article  Google Scholar 

  38. Seebauer L, Walter W, Keyl W (2005) Reverse total shoulder arthroplasty for the treatment of defect arthropathy. Oper Orthop Traumatol 17:1–24

    Article  PubMed  Google Scholar 

  39. Favard L, Le Du C, Bicknell R, Sirveaux F, Levigne C, Boileau P, Walch G (2006) Reverse prostheses for cuff tear arthritis (Hamada IV and V) without previous surgery. Nice shoulder course: reverse shoulder arthroplasty. Sauramps Medical, Montpellier, pp 113–123

    Google Scholar 

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Acknowledgements

We thank the research fund of the Department of Orthopaedic and Trauma Surgery of the University of Heidelberg for the financial support of the study. Furthermore, we would like to thank the motion analysis team of the University of Heidelberg, especially Oliver Rettig and Waltraud Schuster, for the practical support during the study. This study was funded by the Research fund of the Department of Orthopaedic and Trauma Surgery of the Hospital of the University of Heidelberg.

Conflict of interest

All authors, their immediate family, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.

Ethical standards

The local ethics committee approved the study (S-305/2007) and all patients consented to the study.

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Correspondence to Michael W. Maier.

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Maier, M.W., Caspers, M., Zeifang, F. et al. 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 (2014). https://doi.org/10.1007/s00402-014-2015-7

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  • DOI: https://doi.org/10.1007/s00402-014-2015-7

Keywords

  • Reverse shoulder arthroplasty
  • Outcome
  • Cuff tear arthropathy
  • 3D video analysis
  • Marker-based system
  • Upper extremity
  • Biomechanic model