PMID- 35472577
OWN - NLM
STAT- MEDLINE
DCOM- 20220920
LR  - 20220920
IS  - 1532-6500 (Electronic)
IS  - 1058-2746 (Linking)
VI  - 31
IP  - 10
DP  - 2022 Oct
TI  - Clinical outcomes related to glenosphere overhang in reverse shoulder 
      arthroplasty using a lateralized humeral design.
PG  - 2106-2115
LID - S1058-2746(22)00402-5 [pii]
LID - 10.1016/j.jse.2022.03.014 [doi]
AB  - BACKGROUND: Previous studies have demonstrated that decreased impingement-free 
      range of motion (ROM) can adversely influence clinical outcomes following reverse 
      shoulder arthroplasty (RSA). Inferior placement of the glenosphere is thought to 
      minimize impingement and its associated sequelae. This study evaluated the 
      relationship between inferior overhang of the glenosphere and clinical outcomes 
      in patients undergoing primary RSA using a lateralized humeral implant design. 
      METHODS: By use of a prospectively collected shoulder arthroplasty database, all 
      primary RSAs performed at our institution between 2007 and 2015 with a single 
      implant design (lateralized humerus and medialized glenoid) and minimum 2-year 
      follow-up were evaluated. Glenosphere overhang in relation to the inferior rim of 
      the glenoid was measured in millimeters on postoperative Grashey radiographs of 
      the shoulder and categorized into tertiles (low, <7.1 mm; medium, 7.1 to 9.9 mm; 
      and high, >9.9 mm). Clinical outcomes of interest comprised the changes between 
      preoperative and postoperative values in the following ROM and outcome score 
      measures: active forward elevation (aFE), active external rotation, American 
      Shoulder and Elbow Surgeons score, Constant-Murley score, Shoulder Pain and 
      Disability Index score, and Simple Shoulder Test score. Random-effects linear 
      models were used to assess univariate and multivariable associations between 
      overhang tertile and change in patient outcomes. Differences in outcomes were 
      further compared using the minimal clinically important difference (MCID). 
      RESULTS: The study identified 284 shoulders in 265 patients. The median follow-up 
      period was 36 months (range, 24-108 months). The median glenosphere inferior 
      overhang was 8.4 mm, with an interquartile range of 6.3-10.6 mm. Plots 
      demonstrated nonlinear relationships between overhang and outcome scores and 
      between overhang and ROM. Patients with high overhang experienced a significantly 
      greater improvement in aFE compared with patients with low overhang (P = .019), 
      which exceeded the MCID. No other differences in ROM and outcome scores between 
      overhang groups exceeded the MCID. For other outcome scores and ROM measurements, 
      there was no significant relationship with glenosphere overhang. Increased 
      overhang was associated with a significantly lower incidence of scapular notching 
      (P = .005). CONCLUSION: Patients undergoing RSA using a lateralized humerus 
      design with greater inferior overhang of the glenosphere demonstrated a 
      significantly greater improvement in aFE and lower rate of notching compared with 
      those with low overhang. No ideal glenosphere overhang range was identified to 
      maximize function in this study.
CI  - Copyright (c) 2022 Journal of Shoulder and Elbow Surgery Board of Trustees. 
      Published by Elsevier Inc. All rights reserved.
FAU - Dean, Ethan W
AU  - Dean EW
AD  - Department of Orthopaedic Surgery and Sports Medicine, University of Florida, 
      Gainesville, FL, USA.
FAU - Dean, Natalie E
AU  - Dean NE
AD  - Department of Biostatistics, University of Florida, Gainesville, FL, USA.
FAU - Wright, Thomas W
AU  - Wright TW
AD  - Department of Orthopaedic Surgery and Sports Medicine, University of Florida, 
      Gainesville, FL, USA.
FAU - Hao, Kevin A
AU  - Hao KA
AD  - College of Medicine, University of Florida, Gainesville, FL, USA.
FAU - Schoch, Bradley S
AU  - Schoch BS
AD  - Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL, USA.
FAU - Farmer, Kevin W
AU  - Farmer KW
AD  - Department of Orthopaedic Surgery and Sports Medicine, University of Florida, 
      Gainesville, FL, USA.
FAU - Struk, Aimee M
AU  - Struk AM
AD  - Department of Orthopaedic Surgery and Sports Medicine, University of Florida, 
      Gainesville, FL, USA.
FAU - King, Joseph J
AU  - King JJ
AD  - Department of Orthopaedic Surgery and Sports Medicine, University of Florida, 
      Gainesville, FL, USA. Electronic address: kingjj@ortho.ufl.edu.
LA  - eng
PT  - Journal Article
DEP - 20220423
PL  - United States
TA  - J Shoulder Elbow Surg
JT  - Journal of shoulder and elbow surgery
JID - 9206499
SB  - IM
MH  - *Arthroplasty, Replacement, Shoulder/adverse effects
MH  - Humans
MH  - Humerus/diagnostic imaging/surgery
MH  - Prosthesis Design
MH  - Range of Motion, Articular
MH  - *Shoulder Joint/diagnostic imaging/surgery
MH  - *Shoulder Prosthesis/adverse effects
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Overhang
OT  - glenoid baseplate
OT  - glenosphere placement
OT  - impingement
OT  - inferior
OT  - range of motion
OT  - scapular notching
EDAT- 2022/04/27 06:00
MHDA- 2022/09/21 06:00
CRDT- 2022/04/26 20:09
PHST- 2021/12/19 00:00 [received]
PHST- 2022/03/06 00:00 [revised]
PHST- 2022/03/14 00:00 [accepted]
PHST- 2022/04/27 06:00 [pubmed]
PHST- 2022/09/21 06:00 [medline]
PHST- 2022/04/26 20:09 [entrez]
AID - S1058-2746(22)00402-5 [pii]
AID - 10.1016/j.jse.2022.03.014 [doi]
PST - ppublish
SO  - J Shoulder Elbow Surg. 2022 Oct;31(10):2106-2115. doi: 10.1016/j.jse.2022.03.014. 
      Epub 2022 Apr 23.