Subscapularis Tendon Repair Improves Functional Internal Rotation after Onlay Design Reverse Shoulder Arthroplasty
Background: A major challenge of the reverse shoulder arthroplasty (RSA) is to restore postoperative range of motion, especially internal and external rotation. Attempting to address this issue, several modifications to the prosthesis design have been made. Purpose: This study aimed to compare fu...
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The Hive - Musculoskeletal S.A.
2025-01-01
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| author | Felipe Lacerda Alexandre Lädermann Mahmoud Faisal Adam Angélique Delarue Céline Daniel Philippe Collin |
| author_facet | Felipe Lacerda Alexandre Lädermann Mahmoud Faisal Adam Angélique Delarue Céline Daniel Philippe Collin |
| author_sort | Felipe Lacerda |
| collection | DOAJ |
| description | Background: A major challenge of the reverse shoulder arthroplasty (RSA) is to restore postoperative range of motion, especially internal and external rotation. Attempting to address this issue, several modifications to the prosthesis design have been made.
Purpose: This study aimed to compare functional internal rotation (fIR) outcomes following RSA with different humeral implant designs.
Methods: We conducted a retrospective comparative analysis of data from 384 patients, each with a minimum of two years of follow-up, who underwent RSA with two distinct implant models: an inlay 155° neck-shaft angle and an onlay 145° neck-shaft angle. We assessed the postoperative progress of fIR based on type I IR (with the hand blocked against the buttock), type II IR (involving lumbar sliding), and type III IR (characterized by smooth motion). We categorized type I as non-fIR, while types II and III were considered as fIR. To analyze the influence of subscapularis repair on fRI, both groups were further categorized into two subgroups: those with repaired subscapularis (subgroup R) and those without repaired subscapularis (subgroup NR).
Results: No statistically significant difference was observed when comparing postoperative fIR between the two groups. Within the entire cohort, patients in subgroup R exhibited superior fIR outcomes compared to subgroup NR (40% type III vs. 19% type III, respectively; p<0.0001). In the inlay group, no statistically significant difference in fIR was found among subgroups. Conversely, patients in the onlay subgroup R demonstrated better fIR than those in the group NR (42% type III vs. 17% type III, respectively; p<0.0001).
Conclusion: There was no significant difference in fIR following RSA based on humeral design. However, in subgroup R, there was an improvement in fIR for group onlay, but no significant impact was observed in the inlay group. These results suggest that subscapularis repair should be attempted in lateralized designs whenever possible. Patients with higher preoperative IR were more likely to experience a decrease in IR after surgery. |
| format | Article |
| id | doaj-art-7aaa8fccb14b4d6f98937a6e603bb128 |
| institution | DOAJ |
| issn | 3042-5727 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | The Hive - Musculoskeletal S.A. |
| record_format | Article |
| series | The Hive |
| spelling | doaj-art-7aaa8fccb14b4d6f98937a6e603bb1282025-08-20T02:55:10ZengThe Hive - Musculoskeletal S.A.The Hive3042-57272025-01-0111https://doi.org/10.70885/hmsj.2025.01.002Subscapularis Tendon Repair Improves Functional Internal Rotation after Onlay Design Reverse Shoulder ArthroplastyFelipe LacerdaAlexandre LädermannMahmoud Faisal AdamAngélique DelarueCéline DanielPhilippe CollinBackground: A major challenge of the reverse shoulder arthroplasty (RSA) is to restore postoperative range of motion, especially internal and external rotation. Attempting to address this issue, several modifications to the prosthesis design have been made. Purpose: This study aimed to compare functional internal rotation (fIR) outcomes following RSA with different humeral implant designs. Methods: We conducted a retrospective comparative analysis of data from 384 patients, each with a minimum of two years of follow-up, who underwent RSA with two distinct implant models: an inlay 155° neck-shaft angle and an onlay 145° neck-shaft angle. We assessed the postoperative progress of fIR based on type I IR (with the hand blocked against the buttock), type II IR (involving lumbar sliding), and type III IR (characterized by smooth motion). We categorized type I as non-fIR, while types II and III were considered as fIR. To analyze the influence of subscapularis repair on fRI, both groups were further categorized into two subgroups: those with repaired subscapularis (subgroup R) and those without repaired subscapularis (subgroup NR). Results: No statistically significant difference was observed when comparing postoperative fIR between the two groups. Within the entire cohort, patients in subgroup R exhibited superior fIR outcomes compared to subgroup NR (40% type III vs. 19% type III, respectively; p<0.0001). In the inlay group, no statistically significant difference in fIR was found among subgroups. Conversely, patients in the onlay subgroup R demonstrated better fIR than those in the group NR (42% type III vs. 17% type III, respectively; p<0.0001). Conclusion: There was no significant difference in fIR following RSA based on humeral design. However, in subgroup R, there was an improvement in fIR for group onlay, but no significant impact was observed in the inlay group. These results suggest that subscapularis repair should be attempted in lateralized designs whenever possible. Patients with higher preoperative IR were more likely to experience a decrease in IR after surgery.https://thehive-musculoskeletal.com/articles/677bcce3c8b3e82d1e6714be/detailprosthesisonlayinlayprosthetic designrange of motioncomplicationsproms |
| spellingShingle | Felipe Lacerda Alexandre Lädermann Mahmoud Faisal Adam Angélique Delarue Céline Daniel Philippe Collin Subscapularis Tendon Repair Improves Functional Internal Rotation after Onlay Design Reverse Shoulder Arthroplasty The Hive prosthesis onlay inlay prosthetic design range of motion complications proms |
| title | Subscapularis Tendon Repair Improves Functional Internal Rotation after Onlay Design Reverse Shoulder Arthroplasty |
| title_full | Subscapularis Tendon Repair Improves Functional Internal Rotation after Onlay Design Reverse Shoulder Arthroplasty |
| title_fullStr | Subscapularis Tendon Repair Improves Functional Internal Rotation after Onlay Design Reverse Shoulder Arthroplasty |
| title_full_unstemmed | Subscapularis Tendon Repair Improves Functional Internal Rotation after Onlay Design Reverse Shoulder Arthroplasty |
| title_short | Subscapularis Tendon Repair Improves Functional Internal Rotation after Onlay Design Reverse Shoulder Arthroplasty |
| title_sort | subscapularis tendon repair improves functional internal rotation after onlay design reverse shoulder arthroplasty |
| topic | prosthesis onlay inlay prosthetic design range of motion complications proms |
| url | https://thehive-musculoskeletal.com/articles/677bcce3c8b3e82d1e6714be/detail |
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