Glenosphere inclination and clinical outcomes after reverse shoulder arthroplasty |
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| Institution: | 1. University of Virginia, Charlottesville, VA, USA;2. Jordan-Young Institute, Virginia Beach, VA, USA;3. Banner Health, Phoenix, AZ, USA;4. The Cleveland Shoulder Institute, Beachwood, OH, USA;5. Southern Oregon Orthopedics, Medford, OR, USA;1. Department of Orthopaedic Surgery, Beaumont Health, Royal Oak, MI, USA;2. Department of Orthopaedic Research, Beaumont Health, Royal Oak, MI, USA;3. Oakland University William Beaumont School of Medicine, Rochester, MI, USA;4. Department of Surgery, Oakland University William Beaumont School of Medicine, Rochester, MI, USA;1. Southern Oregon Orthopedics, Medford, OR, USA;2. Department of Orthopaedic & Rehabilitation, Oregon Health & Science University, Portland, OR, USA;3. University of Virginia, Charlottesville, VA, USA;4. The Cleveland Shoulder Institute, Beachwood, OH, USA;5. Mayo Clinic, Scottsdale, AZ, USA;6. Steadman Hawkins Clinic of the Carolinas, Greenville, SC, USA;7. University of Arizona College of Medicine - Phoenix, Phoenix AZ, USA;1. Permanente Northwest, Skyline Medical Office, Salem, OR, USA;2. Penn State University, College of Medicine, Milton S Hershey Medical Center, Hershey, PA, USA;3. Penn State University Harrisburg Campus, Department of Mechanical Engineering, York, PA, USA;1. University of Arizona College of Medicine, Phoenix, AZ, USA;2. Cleveland Shoulder Institute, Cleveland, OH, USA;3. Banner Health, Phoenix, AZ, USA;1. Oregon Shoulder Institute, Medford, OR, USA;2. University of Virginia, Charlottesville, VA, USA;3. Orthopedic Practice Clinic, Munster, Germany;4. University of Missouri, Missouri Orthopaedic Institute, Columbia, MO, USA;5. University of Pittsburgh/UPMC, Department of Orthopaedic Surgery, Pittsburgh, PA, USA;6. Western Orthopaedics, Denver, CO, USA;7. Department of Orthopaedic Surgery, Adena Medical Center, Chillicothe, OH, USA;8. Deutsches Gelenkzentrum Heidelberg, ATOS-Klinik, Heidelberg, Germany;9. University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA;1. Florida Orthopaedic Institute, Shoulder and Elbow Service, Tampa, FL, USA;2. Foundation for Orthopaedic Research and Education, Translational Research, Tampa, FL, USA;3. University of South Florida, Department of Medical Engineering, College of Engineering & Morsani College of Medicine, Tampa, FL, USA;4. University of South Florida, Tampa, FL, USA |
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| Abstract: | BackgroundThe relationship of numerous implant design and positioning-related variables with range of motion and clinical outcomes have been investigated for reverse shoulder arthroplasty (RSA). While glenosphere inclination has been investigated with regards to implant fixation and scapular notching, little research has been done on the association between glenosphere inclination and clinical outcomes. Therefore, the primary objective of this study was to investigate the relationship between preoperative glenoid inclination, postoperative glenosphere inclination and inclination change (∆INC) from pre- to postoperative on clinical outcomes after RSA.MethodsA multicenter retrospective study was conducted of RSAs with minimum 2-year clinical follow-up. All included patients had the same RSA prosthesis. Preoperative, postoperative, and ∆INC from pre-to postoperatively were measured for each patient. The primary study outcome was the minimum 2-year ASES score. Secondary outcomes were active range of motion, Constant-Murley score and Western Ontario Ostearthritis Shoulder (WOOS) score at a minimum of 2 years postoperatively. Receiver-operator characteristic curve analyses were performed to determine if any significant thresholds in inclination existed. Univariate analyses were performed with ANOVA to compare subgroup means. Finally, a multivariate logistic regression was performed to examine each inclination variable as a predictor of clinical outcome while controlling for patient and implant-related variables.ResultsEighty seven patients were included in the study. The mean age was 70 years and 53% of patients were male. The examiners had excellent reliability determined by intraclass correlation coefficients for all 3 measurements. There was no apparent correlation between preoperative inclination, postoperative inclination or ∆INC with minimum 2-year ASES scores. This was confirmed in the receiver-operator characteristic analyses, where no significant thresholds were found for each of the 3 assessed measurements (P> .05 for all analyses). A subgroup analysis comparing patients with low preoperative inclination (<10°) and patients with high preoperative inclination (>10°) stratified by the ∆INC demonstrated no significant association with inclination (P > .05 for all comparisons). In the multivariate regression analysis, inclination had no significant association with the minimum 2-year ASES scores.ConclusionFor the studied implant system, preoperative inclination, postoperative inclination and ∆INC did not have a significant association with postoperative clinical outcomes after RSA.Level of evidenceLevel III; Retrospective Comparison Study |
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