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Do Less Medialized Reverse Shoulder Prostheses Increase Motion and Reduce Notching?

  • Symposium: Reverse Total Shoulder Arthroplasty
  • Published:
Clinical Orthopaedics and Related Research®

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Abstract

Background

Cuff tear arthropathy is the primary indication for total reverse shoulder arthroplasty. In patients with pseudoparalytic shoulders secondary to irreparable rotator cuff tear, reverse shoulder arthroplasty allows restoration of active anterior elevation and painless shoulder. High rates of glenoid notching have also been reported. We designed a new reverse shoulder arthroplasty with a center of rotation more lateral than the Delta prosthesis to address this problem.

Questions/purposes

Does reduced medialization of reverse shoulder arthroplasty improve shoulder motion, decrease glenoid notching, or increase the risk of glenoid loosening?

Patients and Methods

We retrospectively reviewed 76 patients with 76 less medialized reverse shoulder prostheses implanted for pseudoparalytic shoulder with rotator cuff deficiency between October 2003 and May 2006. Shoulder motion, Constant-Murley score, and plain radiographs were analyzed. Minimum followup was 24 months (mean, 44 months; range, 24–60 months).

Results

The absolute Constant-Murley score increased from 24 to 59, representing an increase of 35 points. The range of active anterior elevation increased by 61°, and the improvement in pain was 10 points. The gain in external rotation with elbow at the side was 15°, while external rotation with 90° abduction increased by 30°. Followup showed no glenoid notching and no glenoid loosening with these less medialized reverse prostheses.

Conclusions

Less medialization of reverse shoulder arthroplasty improves external and medial rotation, thus facilitating the activities of daily living of older patients. The absence of glenoid notching and glenoid loosening hopefully reflects longer prosthesis survival, but longer followup is necessary to confirm these preliminary observations.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

The authors thank Doctor Peter Hughes, Royal Preston and Chorley Hospital, United Kingdom, for his advice.

Author information

Authors and Affiliations

  1. Institut de la main, Clinique Jouvenet, 6 square Jouvenet, 75016, Paris, France

    Philippe Valenti MD, Philippe Sauzières MD, Ibrahim Kalouche MD & Alexandre Sahin Kilinc MD

  2. Clinique du Ter, Ploemeur, France

    Denis Katz MD

  3. Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75012, Paris, France

    Alexandre Sahin Kilinc MD

Authors
  1. Philippe Valenti MD
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  2. Philippe Sauzières MD
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  3. Denis Katz MD
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  4. Ibrahim Kalouche MD
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  5. Alexandre Sahin Kilinc MD
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Corresponding author

Correspondence to Alexandre Sahin Kilinc MD.

Additional information

One or more of the authors (PV, PS, DK) are consultants for Fournitures Hospitalières Industrie (Mulhouse, France) and have received royalties for a product related to this work. The remaining authors certify that they have no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that all investigations were conducted in conformity with ethical principles of research and that informed consent for participation in the study was obtained.

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Valenti, P., Sauzières, P., Katz, D. et al. Do Less Medialized Reverse Shoulder Prostheses Increase Motion and Reduce Notching?. Clin Orthop Relat Res 469, 2550–2557 (2011). https://doi.org/10.1007/s11999-011-1844-8

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  • DOI: https://doi.org/10.1007/s11999-011-1844-8

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