The Effect of Reverse Shoulder Arthroplasty Design and Surgical Indications on Deltoid and Rotator Cuff Muscle Length
Advancements in surgical planning, technique, and prosthesis design have improved adaptation to patient anatomy in reverse total shoulder arthroplasty (rTSA). Postoperative changes in deltoid and rotator cuff muscle length are important and may vary based on preoperative indications and prosthesis s...
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| creator | Maxwell, Michael J. Glass, Evan A. Bowler, Adam R. Koechling, Zoe Lohre, Ryan Diestel, Declan R. McDonald-Stahl, Miranda Bartels, Ward Vancleef, Sanne Murthi, Anand Smith, Matthew J. Cuff, Derek J. Austin, Luke S. Wiater, J Michael Chamberlain, Aaron Kirsch, Jacob M. Bishai, Shariff K. Favorito, Paul Chalmers, Peter Le, Kiet Jawa, Andrew |
| description | Advancements in surgical planning, technique, and prosthesis design have improved adaptation to patient anatomy in reverse total shoulder arthroplasty (rTSA). Postoperative changes in deltoid and rotator cuff muscle length are important and may vary based on preoperative indications and prosthesis selection. The purpose of this study is to demonstrate the changes in deltoid and rotator cuff muscle length for planned rTSA using the spectrum of prosthesis configurations in both GHOA and RCA.
Ten shoulder arthroplasty surgeons used preoperative planning software to plan rTSA cases for 20 subjects (10 GHOA, 10 RCA) following surgical guidelines. Each surgeon planned each case using three prosthesis configurations: (1) 8-mm lateralized glenosphere and 135° neck-shaft angle (135+8), (2) 4-mm lateralized glenosphere and 145° neck-shaft angle (145+4), and (3) 0-mm lateralized glenosphere and 155° neck-shaft angle (155+0). Pre- and postoperative deltoid and rotator cuff muscle lengths and percentage-change were calculated and compared between prosthesis configurations within each indication. Different muscle lines of action were included representing the deltoid, subscapularis, infraspinatus, and teres minor.
Preoperatively, the RCA cohort had significantly shorter muscle lines of action in the posterior, lateral, and anterior deltoid (P |
| doi_str_mv | 10.1016/j.jse.2024.10.003 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3146531916</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1058274624008723</els_id><sourcerecordid>3146531916</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1509-2ba0239e1377dee2eaca821c16d7fff14e2ff8e08dd44ea65b52e9a24294c55a3</originalsourceid><addsrcrecordid>eNp9kE1PGzEQhq2qFVDKD-il8rGXTcdfm131hAItSEGVgJ4txx4njjbr1PYi8e_rNJQjp_nQM680DyGfGcwYsPbbdrbNOOPAZZ1nAOIdOWNK8KZVAO9rD6pr-Fy2p-RjzlsA6CXwE3Iq-lZ0DPozMj1ukF57j7bQ6Ok9PmHKSB82cRocJnqZyibF_WByeaZXmMN6pGZ09GFK62DNQG9HV2sJccw0jhUZSgzuH3Mfiykx0cXkPb2bsh2QLnFcl80n8sGbIePFSz0nv39cPy5umuWvn7eLy2VjmYK-4SsDXPTIxHzuEDkaazrOLGvd3HvPJHLvO4TOOSnRtGqlOPaGS95Lq5QR5-TrMXef4p8Jc9G7kC0OgxkxTlkLJlslWM_airIjalPMOaHX-xR2Jj1rBvpgW291ta0Ptg-rarvefHmJn1Y7dK8X__VW4PsRwPrkU8Cksw04WnQhVePaxfBG_F8OO5C4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3146531916</pqid></control><display><type>article</type><title>The Effect of Reverse Shoulder Arthroplasty Design and Surgical Indications on Deltoid and Rotator Cuff Muscle Length</title><source>Elsevier ScienceDirect Journals Complete - AutoHoldings</source><creator>Maxwell, Michael J. ; Glass, Evan A. ; Bowler, Adam R. ; Koechling, Zoe ; Lohre, Ryan ; Diestel, Declan R. ; McDonald-Stahl, Miranda ; Bartels, Ward ; Vancleef, Sanne ; Murthi, Anand ; Smith, Matthew J. ; Cuff, Derek J. ; Austin, Luke S. ; Wiater, J Michael ; Chamberlain, Aaron ; Kirsch, Jacob M. ; Bishai, Shariff K. ; Favorito, Paul ; Chalmers, Peter ; Le, Kiet ; Jawa, Andrew</creator><creatorcontrib>Maxwell, Michael J. ; Glass, Evan A. ; Bowler, Adam R. ; Koechling, Zoe ; Lohre, Ryan ; Diestel, Declan R. ; McDonald-Stahl, Miranda ; Bartels, Ward ; Vancleef, Sanne ; Murthi, Anand ; Smith, Matthew J. ; Cuff, Derek J. ; Austin, Luke S. ; Wiater, J Michael ; Chamberlain, Aaron ; Kirsch, Jacob M. ; Bishai, Shariff K. ; Favorito, Paul ; Chalmers, Peter ; Le, Kiet ; Jawa, Andrew</creatorcontrib><description>Advancements in surgical planning, technique, and prosthesis design have improved adaptation to patient anatomy in reverse total shoulder arthroplasty (rTSA). Postoperative changes in deltoid and rotator cuff muscle length are important and may vary based on preoperative indications and prosthesis selection. The purpose of this study is to demonstrate the changes in deltoid and rotator cuff muscle length for planned rTSA using the spectrum of prosthesis configurations in both GHOA and RCA.
Ten shoulder arthroplasty surgeons used preoperative planning software to plan rTSA cases for 20 subjects (10 GHOA, 10 RCA) following surgical guidelines. Each surgeon planned each case using three prosthesis configurations: (1) 8-mm lateralized glenosphere and 135° neck-shaft angle (135+8), (2) 4-mm lateralized glenosphere and 145° neck-shaft angle (145+4), and (3) 0-mm lateralized glenosphere and 155° neck-shaft angle (155+0). Pre- and postoperative deltoid and rotator cuff muscle lengths and percentage-change were calculated and compared between prosthesis configurations within each indication. Different muscle lines of action were included representing the deltoid, subscapularis, infraspinatus, and teres minor.
Preoperatively, the RCA cohort had significantly shorter muscle lines of action in the posterior, lateral, and anterior deltoid (P<0.001), a longer inferior subscapularis (P=0.022), and a longer teres minor (P=0.001) than the GHOA cohort. ANOVA and post-hoc analysis showed that post-planning lengths of each deltoid action line were greater in the 155+0 configuration compared to the 135+8 configuration in the RCA cohort (P<0.001, P=0.003, P=0.032, respectively), and post-planning lengths of the anterior and middle deltoid action lines were also greater for the same comparison in the GHOA cohort (P=0.004 and P=0.017, respectively). There were no significant differences in post-planning deltoid lengths between the 135+8 and 145+4 configurations in either diagnosis cohort (P>0.05). All post-planning rotator cuff muscle lengths (subscapularis, infraspinatus, and teres minor) differed significantly (P<0.001) between all prosthesis configurations in both diagnosis cohorts, with the 135+8 configuration resulting in the longest lengths and the 155+0 configuration resulting in the shortest lengths.
Automated preoperative planning software calculates the lengths of muscle action lines, which vary between GHOA and RCA diagnoses. Varying rTSA implant geometries result in predictable differences in deltoid lengthening and rotator cuff shortening. Shoulder prostheses with a more lateralized center of rotation show greater rotator cuff muscle length and similar deltoid muscle length when compared to medialized designs with similar deltoid lengthening. Surgeons can use this software to understand the impact of implant geometry on muscle length.
Basic Science Study; Computer Modeling</description><identifier>ISSN: 1058-2746</identifier><identifier>ISSN: 1532-6500</identifier><identifier>EISSN: 1532-6500</identifier><identifier>DOI: 10.1016/j.jse.2024.10.003</identifier><identifier>PMID: 39638109</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>deltoid length ; glenohumeral osteoarthritis ; prosthesis design ; reverse total shoulder arthroplasty ; rotator cuff ; rotator cuff arthropathy ; surgical planning</subject><ispartof>Journal of shoulder and elbow surgery, 2024-12</ispartof><rights>2024 Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>Copyright © 2024. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jse.2024.10.003$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39638109$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maxwell, Michael J.</creatorcontrib><creatorcontrib>Glass, Evan A.</creatorcontrib><creatorcontrib>Bowler, Adam R.</creatorcontrib><creatorcontrib>Koechling, Zoe</creatorcontrib><creatorcontrib>Lohre, Ryan</creatorcontrib><creatorcontrib>Diestel, Declan R.</creatorcontrib><creatorcontrib>McDonald-Stahl, Miranda</creatorcontrib><creatorcontrib>Bartels, Ward</creatorcontrib><creatorcontrib>Vancleef, Sanne</creatorcontrib><creatorcontrib>Murthi, Anand</creatorcontrib><creatorcontrib>Smith, Matthew J.</creatorcontrib><creatorcontrib>Cuff, Derek J.</creatorcontrib><creatorcontrib>Austin, Luke S.</creatorcontrib><creatorcontrib>Wiater, J Michael</creatorcontrib><creatorcontrib>Chamberlain, Aaron</creatorcontrib><creatorcontrib>Kirsch, Jacob M.</creatorcontrib><creatorcontrib>Bishai, Shariff K.</creatorcontrib><creatorcontrib>Favorito, Paul</creatorcontrib><creatorcontrib>Chalmers, Peter</creatorcontrib><creatorcontrib>Le, Kiet</creatorcontrib><creatorcontrib>Jawa, Andrew</creatorcontrib><title>The Effect of Reverse Shoulder Arthroplasty Design and Surgical Indications on Deltoid and Rotator Cuff Muscle Length</title><title>Journal of shoulder and elbow surgery</title><addtitle>J Shoulder Elbow Surg</addtitle><description>Advancements in surgical planning, technique, and prosthesis design have improved adaptation to patient anatomy in reverse total shoulder arthroplasty (rTSA). Postoperative changes in deltoid and rotator cuff muscle length are important and may vary based on preoperative indications and prosthesis selection. The purpose of this study is to demonstrate the changes in deltoid and rotator cuff muscle length for planned rTSA using the spectrum of prosthesis configurations in both GHOA and RCA.
Ten shoulder arthroplasty surgeons used preoperative planning software to plan rTSA cases for 20 subjects (10 GHOA, 10 RCA) following surgical guidelines. Each surgeon planned each case using three prosthesis configurations: (1) 8-mm lateralized glenosphere and 135° neck-shaft angle (135+8), (2) 4-mm lateralized glenosphere and 145° neck-shaft angle (145+4), and (3) 0-mm lateralized glenosphere and 155° neck-shaft angle (155+0). Pre- and postoperative deltoid and rotator cuff muscle lengths and percentage-change were calculated and compared between prosthesis configurations within each indication. Different muscle lines of action were included representing the deltoid, subscapularis, infraspinatus, and teres minor.
Preoperatively, the RCA cohort had significantly shorter muscle lines of action in the posterior, lateral, and anterior deltoid (P<0.001), a longer inferior subscapularis (P=0.022), and a longer teres minor (P=0.001) than the GHOA cohort. ANOVA and post-hoc analysis showed that post-planning lengths of each deltoid action line were greater in the 155+0 configuration compared to the 135+8 configuration in the RCA cohort (P<0.001, P=0.003, P=0.032, respectively), and post-planning lengths of the anterior and middle deltoid action lines were also greater for the same comparison in the GHOA cohort (P=0.004 and P=0.017, respectively). There were no significant differences in post-planning deltoid lengths between the 135+8 and 145+4 configurations in either diagnosis cohort (P>0.05). All post-planning rotator cuff muscle lengths (subscapularis, infraspinatus, and teres minor) differed significantly (P<0.001) between all prosthesis configurations in both diagnosis cohorts, with the 135+8 configuration resulting in the longest lengths and the 155+0 configuration resulting in the shortest lengths.
Automated preoperative planning software calculates the lengths of muscle action lines, which vary between GHOA and RCA diagnoses. Varying rTSA implant geometries result in predictable differences in deltoid lengthening and rotator cuff shortening. Shoulder prostheses with a more lateralized center of rotation show greater rotator cuff muscle length and similar deltoid muscle length when compared to medialized designs with similar deltoid lengthening. Surgeons can use this software to understand the impact of implant geometry on muscle length.
Basic Science Study; Computer Modeling</description><subject>deltoid length</subject><subject>glenohumeral osteoarthritis</subject><subject>prosthesis design</subject><subject>reverse total shoulder arthroplasty</subject><subject>rotator cuff</subject><subject>rotator cuff arthropathy</subject><subject>surgical planning</subject><issn>1058-2746</issn><issn>1532-6500</issn><issn>1532-6500</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kE1PGzEQhq2qFVDKD-il8rGXTcdfm131hAItSEGVgJ4txx4njjbr1PYi8e_rNJQjp_nQM680DyGfGcwYsPbbdrbNOOPAZZ1nAOIdOWNK8KZVAO9rD6pr-Fy2p-RjzlsA6CXwE3Iq-lZ0DPozMj1ukF57j7bQ6Ok9PmHKSB82cRocJnqZyibF_WByeaZXmMN6pGZ09GFK62DNQG9HV2sJccw0jhUZSgzuH3Mfiykx0cXkPb2bsh2QLnFcl80n8sGbIePFSz0nv39cPy5umuWvn7eLy2VjmYK-4SsDXPTIxHzuEDkaazrOLGvd3HvPJHLvO4TOOSnRtGqlOPaGS95Lq5QR5-TrMXef4p8Jc9G7kC0OgxkxTlkLJlslWM_airIjalPMOaHX-xR2Jj1rBvpgW291ta0Ptg-rarvefHmJn1Y7dK8X__VW4PsRwPrkU8Cksw04WnQhVePaxfBG_F8OO5C4</recordid><startdate>20241203</startdate><enddate>20241203</enddate><creator>Maxwell, Michael J.</creator><creator>Glass, Evan A.</creator><creator>Bowler, Adam R.</creator><creator>Koechling, Zoe</creator><creator>Lohre, Ryan</creator><creator>Diestel, Declan R.</creator><creator>McDonald-Stahl, Miranda</creator><creator>Bartels, Ward</creator><creator>Vancleef, Sanne</creator><creator>Murthi, Anand</creator><creator>Smith, Matthew J.</creator><creator>Cuff, Derek J.</creator><creator>Austin, Luke S.</creator><creator>Wiater, J Michael</creator><creator>Chamberlain, Aaron</creator><creator>Kirsch, Jacob M.</creator><creator>Bishai, Shariff K.</creator><creator>Favorito, Paul</creator><creator>Chalmers, Peter</creator><creator>Le, Kiet</creator><creator>Jawa, Andrew</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20241203</creationdate><title>The Effect of Reverse Shoulder Arthroplasty Design and Surgical Indications on Deltoid and Rotator Cuff Muscle Length</title><author>Maxwell, Michael J. ; Glass, Evan A. ; Bowler, Adam R. ; Koechling, Zoe ; Lohre, Ryan ; Diestel, Declan R. ; McDonald-Stahl, Miranda ; Bartels, Ward ; Vancleef, Sanne ; Murthi, Anand ; Smith, Matthew J. ; Cuff, Derek J. ; Austin, Luke S. ; Wiater, J Michael ; Chamberlain, Aaron ; Kirsch, Jacob M. ; Bishai, Shariff K. ; Favorito, Paul ; Chalmers, Peter ; Le, Kiet ; Jawa, Andrew</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1509-2ba0239e1377dee2eaca821c16d7fff14e2ff8e08dd44ea65b52e9a24294c55a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>deltoid length</topic><topic>glenohumeral osteoarthritis</topic><topic>prosthesis design</topic><topic>reverse total shoulder arthroplasty</topic><topic>rotator cuff</topic><topic>rotator cuff arthropathy</topic><topic>surgical planning</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maxwell, Michael J.</creatorcontrib><creatorcontrib>Glass, Evan A.</creatorcontrib><creatorcontrib>Bowler, Adam R.</creatorcontrib><creatorcontrib>Koechling, Zoe</creatorcontrib><creatorcontrib>Lohre, Ryan</creatorcontrib><creatorcontrib>Diestel, Declan R.</creatorcontrib><creatorcontrib>McDonald-Stahl, Miranda</creatorcontrib><creatorcontrib>Bartels, Ward</creatorcontrib><creatorcontrib>Vancleef, Sanne</creatorcontrib><creatorcontrib>Murthi, Anand</creatorcontrib><creatorcontrib>Smith, Matthew J.</creatorcontrib><creatorcontrib>Cuff, Derek J.</creatorcontrib><creatorcontrib>Austin, Luke S.</creatorcontrib><creatorcontrib>Wiater, J Michael</creatorcontrib><creatorcontrib>Chamberlain, Aaron</creatorcontrib><creatorcontrib>Kirsch, Jacob M.</creatorcontrib><creatorcontrib>Bishai, Shariff K.</creatorcontrib><creatorcontrib>Favorito, Paul</creatorcontrib><creatorcontrib>Chalmers, Peter</creatorcontrib><creatorcontrib>Le, Kiet</creatorcontrib><creatorcontrib>Jawa, Andrew</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of shoulder and elbow surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maxwell, Michael J.</au><au>Glass, Evan A.</au><au>Bowler, Adam R.</au><au>Koechling, Zoe</au><au>Lohre, Ryan</au><au>Diestel, Declan R.</au><au>McDonald-Stahl, Miranda</au><au>Bartels, Ward</au><au>Vancleef, Sanne</au><au>Murthi, Anand</au><au>Smith, Matthew J.</au><au>Cuff, Derek J.</au><au>Austin, Luke S.</au><au>Wiater, J Michael</au><au>Chamberlain, Aaron</au><au>Kirsch, Jacob M.</au><au>Bishai, Shariff K.</au><au>Favorito, Paul</au><au>Chalmers, Peter</au><au>Le, Kiet</au><au>Jawa, Andrew</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effect of Reverse Shoulder Arthroplasty Design and Surgical Indications on Deltoid and Rotator Cuff Muscle Length</atitle><jtitle>Journal of shoulder and elbow surgery</jtitle><addtitle>J Shoulder Elbow Surg</addtitle><date>2024-12-03</date><risdate>2024</risdate><issn>1058-2746</issn><issn>1532-6500</issn><eissn>1532-6500</eissn><abstract>Advancements in surgical planning, technique, and prosthesis design have improved adaptation to patient anatomy in reverse total shoulder arthroplasty (rTSA). Postoperative changes in deltoid and rotator cuff muscle length are important and may vary based on preoperative indications and prosthesis selection. The purpose of this study is to demonstrate the changes in deltoid and rotator cuff muscle length for planned rTSA using the spectrum of prosthesis configurations in both GHOA and RCA.
Ten shoulder arthroplasty surgeons used preoperative planning software to plan rTSA cases for 20 subjects (10 GHOA, 10 RCA) following surgical guidelines. Each surgeon planned each case using three prosthesis configurations: (1) 8-mm lateralized glenosphere and 135° neck-shaft angle (135+8), (2) 4-mm lateralized glenosphere and 145° neck-shaft angle (145+4), and (3) 0-mm lateralized glenosphere and 155° neck-shaft angle (155+0). Pre- and postoperative deltoid and rotator cuff muscle lengths and percentage-change were calculated and compared between prosthesis configurations within each indication. Different muscle lines of action were included representing the deltoid, subscapularis, infraspinatus, and teres minor.
Preoperatively, the RCA cohort had significantly shorter muscle lines of action in the posterior, lateral, and anterior deltoid (P<0.001), a longer inferior subscapularis (P=0.022), and a longer teres minor (P=0.001) than the GHOA cohort. ANOVA and post-hoc analysis showed that post-planning lengths of each deltoid action line were greater in the 155+0 configuration compared to the 135+8 configuration in the RCA cohort (P<0.001, P=0.003, P=0.032, respectively), and post-planning lengths of the anterior and middle deltoid action lines were also greater for the same comparison in the GHOA cohort (P=0.004 and P=0.017, respectively). There were no significant differences in post-planning deltoid lengths between the 135+8 and 145+4 configurations in either diagnosis cohort (P>0.05). All post-planning rotator cuff muscle lengths (subscapularis, infraspinatus, and teres minor) differed significantly (P<0.001) between all prosthesis configurations in both diagnosis cohorts, with the 135+8 configuration resulting in the longest lengths and the 155+0 configuration resulting in the shortest lengths.
Automated preoperative planning software calculates the lengths of muscle action lines, which vary between GHOA and RCA diagnoses. Varying rTSA implant geometries result in predictable differences in deltoid lengthening and rotator cuff shortening. Shoulder prostheses with a more lateralized center of rotation show greater rotator cuff muscle length and similar deltoid muscle length when compared to medialized designs with similar deltoid lengthening. Surgeons can use this software to understand the impact of implant geometry on muscle length.
Basic Science Study; Computer Modeling</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39638109</pmid><doi>10.1016/j.jse.2024.10.003</doi></addata></record> |
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| source | Elsevier ScienceDirect Journals Complete - AutoHoldings |
| subjects | deltoid length glenohumeral osteoarthritis prosthesis design reverse total shoulder arthroplasty rotator cuff rotator cuff arthropathy surgical planning |
| title | The Effect of Reverse Shoulder Arthroplasty Design and Surgical Indications on Deltoid and Rotator Cuff Muscle Length |
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