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Factors that affect external rotation following reverse shoulder arthroplasty: a retrospective multi-centre study on 501 shoulders

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The purpose of this multi-centre study was to assess external rotation in a large cohort following reverse shoulder arthroplasty (RSA) at a minimum follow-up of 2 years, and identify factors that influence postoperative and/or net-improvement of external rotation.

Methods

The authors retrospectively reviewed records of 743 RSAs performed between January 2015 and August 2017 by 16 surgeons that participated in a large national society symposium; 193 (25.7%) were lost to follow-up, 16 (2.1%) died, and 33 (4.4%) were revised with implant exchange, which left 501 available for assessment at 2.0–5.5 years. Pre- and post-operative active forward elevation, active external rotation (ER1), active internal rotation (IR1) and constant score (CS) were collected. Regression analyses were performed to determine associations of patient demographics, surgical and implant parameters, rotator cuff muscles status and radiographic angles with ER1.

Results

Multivariable analyses revealed postoperative ER1 decreased with age (β, − 0.35), increased with lateralisation shoulder angle (LSA) (β, 0.26), and was better in shoulders operated by the antero-superior (AS) approach (β, 11.41), but worse in shoulders with absent/atrophic teres minor muscles (β, − 10.06). Net-improvement of ER1 increased with LSA (β, 0.39), was better with inlay stems (β, 8.33) and BIO RSA (β, 6.22), but worse in shoulders operated for primary OA with rotator cuff (RC) tears (β, − 16.26), for secondary OA due to RC tears (β, − 16.06), or for mRCT (β, − 18.96).

Conclusions

This large multi-centre study revealed that, at a minimum of 2 years following RSA, ER1 improved by 16.1°. Postoperative ER1 was better in shoulders which had normal or hypertrophic teres minor muscles, were operated by the AS approach, or with greater LSA. Net-improvement of ER1 was better in shoulders with inlay stems, with BIO RSA, or with greater LSA, but worse in shoulders with rotator cuff deficiency.

Level of evidence

IV.

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The authors would consider making raw data available on request.

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Acknowledgements

Contributors of ReSurg: Jacobus H Müller6, Aude Hibon6, Luca Nover6, Mo Saffarini6.

Funding

The authors are grateful to ELSAN for funding the statistical analysis and manuscript preparation for this study.

Author information

Authors and Affiliations

  1. Université Claude Bernard Lyon 1, 43 Bd du 11 Novembre 1918, 69100, Villeurbanne, France

    Louis Ducharne

  2. Centre Orthopédique Santy, Hôpital Privé Jean Mermoz, Ramsay Santé, Lyon, France

    Arnaud Godenèche

  3. SoFEC-French Shoulder and Elbow Society, 75014, Paris, France

    Arnaud Godenèche & Cécile Nérot

  4. Orthopaedic and Traumatology Department, Reims University Hospital, Reims, France

    Cécile Nérot

  5. Institut de Chirurgie Orthopédique et Sportive, Marseille, France

    Richard Aswad

  6. ReSurg S.A., Rue Saint-Jean 22, 1260, Nyon, Switzerland

    Jacobus H. Müller, Aude Hibon, Luca Nover & Mo Saffarini

  7. Clinique du Parc Groupe Elsan, Lyon, France

    Jérôme Garret

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  1. Louis Ducharne
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Consortia

SoFEC

ReSurg

  • Jacobus H. Müller
  • , Aude Hibon
  • , Luca Nover
  •  & Mo Saffarini

Contributions

LD: Data collection, interpretation of findings and manuscript writing. AG: Study design, data collection, interpretation of findings and manuscript editing. CN: Study design, data collection, interpretation of findings and manuscript editing. RA: Study design, data collection, interpretation of findings and manuscript editing. JHM: Manuscript writing. AH: Project management, data collection, and coordination. LN: Statistical analysis, tables and figures. MS: Interpretation of findings, manuscript writing. JG: Procurement of funding, study design, data collection, interpretation of findings manuscript editing.

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LD, RA states that they have no conflicts of interest. AG and JG reports fees from Tornier SAS outside of the submitted work. CN reports support from DePuy Synthes outside the submitted work.

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Informed consent was obtained from all individual participants included in the study.

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Ducharne, L., Godenèche, A., Nérot, C. et al. Factors that affect external rotation following reverse shoulder arthroplasty: a retrospective multi-centre study on 501 shoulders. Arch Orthop Trauma Surg 143, 6487–6496 (2023). https://doi.org/10.1007/s00402-023-04935-6

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