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Early restoration of shoulder function in patients with the Grammont prosthesis compared to lateralized humeral design in reverse shoulder arthroplasty

Authors
 Jae-Hoo Lee  ;  Yong-Min Chun  ;  Doo-Sup Kim  ;  Doo-Hyung Lee  ;  Sang-Jin Shin 
Citation
 JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol.30(11) : 2533-2542, 2021-11 
Journal Title
JOURNAL OF SHOULDER AND ELBOW SURGERY
ISSN
 1058-2746 
Issue Date
2021-11
MeSH
Arthroplasty, Replacement, Shoulder* ; Humans ; Humerus / diagnostic imaging ; Humerus / surgery ; Prostheses and Implants ; Prosthesis Design ; Range of Motion, Articular ; Shoulder ; Shoulder Joint* / diagnostic imaging ; Shoulder Joint* / surgery ; Shoulder Prosthesis* ; Treatment Outcome
Keywords
Grammont prosthesis ; Reverse shoulder arthroplasty ; cuff tear arthroplasty ; lateralized humeral design ; rotator cuff tear ; scapular notching
Abstract
Background: This study aimed to compare the clinical outcomes and radiographic parameters of patients after reverse shoulder arthroplasty (RSA) between the Grammont prosthesis and lateralized humeral design prosthesis.

Methods: A total of 114 patients who underwent RSA with a lateralized humeral design (group L; 71 shoulders) and medialized humeral design (group M; 43 shoulders) prosthesis for cuff tear arthropathy or irreparable rotator cuff tear were enrolled. Clinical outcomes including visual analog scale (VAS), American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), and Constant scores and range of motion (ROM) were serially followed up at postoperative 3, 6, 12, and 24 months. Radiographic parameters were measured to evaluate preoperative and postoperative status.

Results: Both prostheses demonstrated similar clinical outcomes and shoulder function preoperatively and at postoperative 2 years (P >.05). However, patients in group M had significantly better postoperative active forward flexion (postoperative 3 months, 115° ± 12° vs. 101° ± 14°; P <.001; 6 months, 125° ± 13° vs. 118° ± 13°; P <.013) and abduction (3 months, 105° ± 12° vs. 98° ± 12°; P = .002); VAS (3 months, 3.1 ± 1.2 vs. 3.7 ± 1.4; P = .031; 6 months, 2.3 ± 1.1 vs. 2.8 ± 1.3; P = .038); ASES (3 months, 64.2 ± 7.0 vs. 60.4 ± 9.2; P = .022; 6 months, 70.6 ± 6.0 vs. 66.6 ± 8.1; P = .007); and Constant scores (6 months, 59.6 ± 6.9 vs. 55.7 ± 9.3; P = .020). Group L showed a significantly lower rate of scapular notching than group M (15.5% vs. 41.8%; P < .001). The position of the proximal humerus in group L was more lateralized and less distalized than in group M after RSA.

Conclusions: RSA with both the Grammont and lateralized humeral design prostheses provided similar shoulder ROM restoration and functional improvements at a minimum of 2 years. However, patients with a humeral lateralized prosthesis showed slower recovery of shoulder function and ROM up to postoperative 6 months despite a lower incidence of scapular notching.
Full Text
https://www.sciencedirect.com/science/article/pii/S1058274621003451?via%3Dihub
DOI
10.1016/j.jse.2021.03.145
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Chun, Yong Min(천용민) ORCID logo https://orcid.org/0000-0002-8147-6136
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187566
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