American Shoulder and Elbow Surgeons Annual Meeting
American Shoulder and Elbow Surgeons Annual Meeting
Perspective from Robert J. Gillespie, MD
November 22, 2019
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Inferior overhang of glenosphere yielded excellent range of motion in reverse shoulder arthroplasty

Perspective from Robert J. Gillespie, MD
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Robert U. Hartzler

NEW YORK — Results presented at the American Shoulder and Elbow Surgeons Annual Meeting showed a larger glenosphere implanted with inferior overhang may be associated with excellent postoperative range of motion after reverse shoulder arthroplasty.

Robert U. Hartzler, MD, and colleagues determined preoperative and postoperative range of motion among 180 patients who underwent reverse shoulder arthroplasty and had a minimum of 1-year follow-up. Hartzler noted they performed a risk factor analysis to compare excellent vs. poor range of motion outcomes.

“Excellent range of motion was defined as forward elevation greater than 140° and external rotation greater than 30° or was defined as forward elevation less than 100° or external rotation less than 15°,” Hartzler said in his presentation here.

According to Hartzler, 75 of the 180 patients had either excellent or poor outcomes. Of the 36 patients with poor outcomes, Hartzler noted 16 patients had a lack of forward elevation and external rotation, 11 patients had poor external rotation alone and nine patients had poor forward elevation.

“Those with poor range of motion outcomes also had worse pain relief and improvement in ASES score,” Hartzler said.

In a univariate risk factor analysis, Hartzler noted an association between higher BMI and excellent range of motion, while young age trended toward significance. He added poor range of motion outcomes were associated with smaller glenospheres and anterior offset positioning of the humeral cup.

Hartzler reported an association between glenosphere overhang and excellent range of motion, according to univariate analysis of radiographic outcomes.

“The odds of excellent range of motion were nine-times and five-times higher with 39-[mm] and 42-[mm] glenospheres vs. a 36-mm glenosphere,” Hartzler said. “Each millimeter of glenosphere overhang resulted in a 1.6-times odds of an excellent outcome, and anterior cup offset was highly associated with poor range of motion outcomes in this model.” – by Casey Tingle

 

Reference:

Denard PJ, et al. Paper 42. Presented at: American Shoulder and Elbow Surgeons Annual Meeting; Oct. 17-19, 2019; New York.

 

Disclosure: Hartzler reports he is a paid consultant and paid presenter or speaker for Arthrex Inc.; is a board or committee member for the Arthroscopy Association of North America; and received publishing royalties, financial or material support from Wolters Kluwer Health – Lippincott Williams & Wilkins.