Clinical and radiological outcomes of a highly lateralized reverse shoulder arthroplasty in patients with a height of 160 cm or less versus a height of 170 cm or more

Abstract

Background

To evaluates the impact of patient height (less than 160 cm and greater than 170 cm) on outcomes of lateralized reverse total shoulder arthroplasty (rTSA).

Method

This retrospective case–control study of 31 lateralized rTSA patients, with follow-ups ranging from 12 to 28 months, was divided into 2 groups: 14 short-stature (≤160 cm) and 17 taller (≥170 cm) patients. Preoperative planning utilized e-ORTHO templating software (FH Orthopaedics, Mulhouse, France), ensuring uniform lateralization shoulder angle and distalization shoulder angles across groups. Primary outcomes included range of motion (ROM), while secondary outcomes comprised Constant Score (absolute/ponderate), subjective shoulder value (SSV), and visual analog scale (VAS). Discrepancies in scores between groups were evaluated for clinical relevance against minimal clinically important difference benchmarks. Incidences of scapular notching were also recorded.

Results

All the clinical parameters analyzed were improved postoperatively in both groups (P < .05). No significant difference was observed in postoperative ROM, ponderate Constant, and VAS between groups (P > .05) except for forward elevation which was higher in the taller group (142.9 ± 27.6 compared to 163.5 ± 11.1 P = .018). For SSV, the taller group had higher postoperative SSV (P = .037). However, the difference was less than the minimal clinically important difference for SSV (−5.97 [95% confidence interval: −10.17 to 1.76], P = .01) and thus was considered not clinically significant. No scapular notching was detected in either group.

Conclusion

When planned positioning angles are respected (lateralization shoulder angle, distalization shoulder angle), the benefits of highly lateralized rTSA are consistent regardless of patient stature. Both groups had comparable results across ROM, ponderate Constant, and VAS except for forward elevation which was higher in the taller group.