Highlights
- •We suggest that change in neck shaft angle and retroversion can prevent scapular notching.
- •We measured shoulder range of motion with change in neck shaft angle (NSA) and retroversion.
- •As NSA and retroversion increase, the amount of adduction deficit also increases.
- •As NSA decreases, amount of total rotation increases.
- •As retroversion increases, amount of internal rotation behind back also increases.
Abstract
Background
We studied combined effect of change in humeral neck shaft angle and retroversion
on shoulder ROM in reverse total shoulder arthroplasty using 3-dimensional simulations.
Methods
Using a 3D model construct based on the CT scans of 3 males and a 3-dimensional analysis
program, a humeral component of reverse total shoulder arthroplasty was implanted
in 0°, 10°, 20°, 30°,40° retroversion and 135°, 145°, and 155° neck shaft angle. Total
horizontal range of motion (sum of horizontal adduction and abduction) at 30° and
60° scaption, adduction in the scapular plane and IR behind the back were measured
for various combinations of neck shaft angle and retroversion.
Findings
Change in retroversion didn't show any effect on total horizontal range of motion.
Total horizontal range of motion at both 30° and 60° scaption, showed maximum values
at 135° neck shaft angle and minimum values at 155° neck shaft angle. With any combination
of retroversion angles, adduction deficit was maximum at 155° neck shaft angle and
no adduction deficit at 135° neck shaft angle. Every 10° decrease in neck shaft angle
resulted in an average 10.4° increase in adduction. For every 10° increase in retroversion,
there was loss of internal rotation behind the back up to at least one vertebral level.
Interpretation
135° neck shaft angle resulted in maximum total horizontal range of motion both at
30° and 60° scaption regardless of retroversion angles. 135° neck shaft angle also
reduced the chances of scapular impingement. Decrease in retroversion angle resulted
in more amount of internal rotation behind the back.
Keywords
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Article info
Publication history
Published online: October 21, 2015
Accepted:
June 24,
2015
Received:
November 24,
2014
Footnotes
☆No author or related institute has received any financial benefit from research in this study. The authors report no conflict of interest.
Identification
Copyright
© 2015 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
