Baseplate version in reverse shoulder arthroplasty: does excessive retroversion or anteversion affect functional activities of daily living?

IF 2 3区医学 Q2 ORTHOPEDICS International Orthopaedics Pub Date : 2024-11-29 DOI:10.1007/s00264-024-06373-4

Mihir M Sheth, Corey J Schiffman, Anastasia J Whitson, Frederick A Matsen, Jason E Hsu

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Abstract

Purpose: While bone grafting and augmented components can help restore reverse shoulder arthroplasty (RSA) baseplate version close to neutral, the indication for version correction in RSA is unclear. The purpose of this study was to compare the clinical outcomes of RSA baseplates in high degrees of retroversion and anteversion to components in more neutral version.

Methods: Patients who underwent RSA with minimum two year follow-up were identified from an institutional registry. An RSA system with a glenosphere that is two-thirds of a sphere was utilized. Post-operative radiographs were used to determine baseplate version, and patients were grouped into four categories: ≥ 10 degrees (moderate to severe anteversion; n = 14), 10 to -10 degrees (neutral; n = 69), -10 to -20 (moderate retroversion; n = 25), and ≤ -20 degrees (severe retroversion; n = 7). The outcomes of interest were ability to perform functions requiring internal rotation, external rotation and cross-body adduction, as well as complications and revisions.

Results: There were no differences in final Simple Shoulder Test (SST), final American Shoulder and Elbow Surgeons score (ASES) or change in SST from pre- to post-operative across the four version groups. There was no linear correlation between baseplate version and final SST. There were no statistically significant differences in difficulty performing tasks related to internal rotation, external rotation, and cross-body adduction among the four baseplate version groups; however, patients with moderate to severe anteversion had a greater frequency of difficulty putting on a coat (86%) compared to patients with neutral version (42%), moderate retroversion (45%) and severe retroversion (0%) (p = 0.021). There were no differences in rates of complications and revisions across the four groups.

Conclusion: This study did not find evidence that high values of baseplate retroversion or anteversion were associated with inferior patient reported outcomes or functional rotation after reverse total shoulder arthroplasty.

Level of evidence: Level 3, retrospective comparative study.

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反向肩关节置换术中的钢板变形：过度后倾或前倾会影响日常生活的功能活动吗？

目的：虽然植骨和增强构件可以帮助恢复反向肩关节置换术（RSA）的底板版本接近中性，但RSA的版本矫正指征尚不清楚。本研究的目的是比较高度前倾和前倾的RSA基板与更中性版本的RSA基板的临床结果。方法：从一个机构注册表中确定接受RSA治疗的患者，随访至少2年。RSA系统的glenosphere是一个球体的三分之二。术后x线片确定底板的前后倾角，将患者分为4组：≥10度(中度至重度前倾；N = 14)， 10至-10度(中性；N = 69)， -10至-20(中度逆行；N = 25)，≤-20度(严重后倾；n = 7)。关注的结果是完成需要内旋、外旋和跨体内收的功能的能力，以及并发症和翻修。结果：四个版本组的最终简单肩关节测试（SST），最终美国肩关节外科医生评分（ASES）或SST从术前到术后的变化没有差异。底板型与最终海温无线性相关。4个底板版本组在完成内旋、外旋和跨体内收相关任务的难度上无统计学差异；然而，中度至重度前倾患者与中度前倾（42%）、中度后倾（45%）和重度后倾（0%）患者相比，穿大衣困难的频率更高（86%）（p = 0.021）。四组的并发症发生率和修复率没有差异。结论：本研究未发现高水平的钢板后倾或前倾与患者报告的不良预后或逆行全肩关节置换术后的功能性旋转相关的证据。证据等级：3级，回顾性比较研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.