Do shoulder kinematics change after reverse total shoulder arthroplasty?

Background: Reverse total shoulder arthroplasty (rTSA) is believed to alter shoulder kinematics. However, it remains unclear whether the kinematic changes observed in shoulders following rTSA were present preoperatively or developed as a result of the surgery. Furthermore, the impact of preoperative...

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Main Authors: Itaru Kawashima, MD, PhD, Eric R. Wagner, MD, MS, Joseph J. King, MD, Zaamin B. Hussain, MD, EdM, Sameer R. Khawaja, BS, Jaden C. Hadrick, BS, Krishna N. Chopra, MA, Michael B. Gottschalk, MD, Scott A. Banks, PhD, Thomas W. Wright, MD
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:JSES International
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666638325001483
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author Itaru Kawashima, MD, PhD
Eric R. Wagner, MD, MS
Joseph J. King, MD
Zaamin B. Hussain, MD, EdM
Sameer R. Khawaja, BS
Jaden C. Hadrick, BS
Krishna N. Chopra, MA
Michael B. Gottschalk, MD
Scott A. Banks, PhD
Thomas W. Wright, MD
author_facet Itaru Kawashima, MD, PhD
Eric R. Wagner, MD, MS
Joseph J. King, MD
Zaamin B. Hussain, MD, EdM
Sameer R. Khawaja, BS
Jaden C. Hadrick, BS
Krishna N. Chopra, MA
Michael B. Gottschalk, MD
Scott A. Banks, PhD
Thomas W. Wright, MD
author_sort Itaru Kawashima, MD, PhD
collection DOAJ
description Background: Reverse total shoulder arthroplasty (rTSA) is believed to alter shoulder kinematics. However, it remains unclear whether the kinematic changes observed in shoulders following rTSA were present preoperatively or developed as a result of the surgery. Furthermore, the impact of preoperative scapulohumeral rhythm (SHR) on the postoperative SHR after rTSA is also poorly understood. The primary aim of this study was to compare shoulder kinematics before and after rTSA using the 3-dimensional (3D) to 2-dimensional model-image registration with dynamic digital radiography images. The secondary purpose was to evaluate whether preoperative SHR correlates with postoperative SHR after rTSA. Methods: Twenty shoulders in 19 patients that underwent rTSA were included. Dynamic digital radiography images were performed preoperatively and 6 months or later postoperatively to assess shoulder motion during scapular plane abduction. 3D surface models of preoperative scapula and humerus, and postoperative scapula and humerus with implants were created from the preoperative and postoperative computed tomography images. Scapular and humeral kinematics were evaluated using a 3D to 2-dimensional model image registration method. Each kinematics parameter was calculated at 10° increments from 20° to 90° of humeral abduction. The mean SHR was also calculated from the humeral position at side to 90° or to the maximum humeral abduction if it was less than 90°. Linear mixed-effects models for repeated measures were used to compare kinematics at each humeral abduction between preoperative and postoperative conditions. The correlation between the preoperative mean SHR and the postoperative mean SHR was assessed using Pearson's product-moment correlation statistic. Results: A significant postoperative increase in scapular posterior tilt was observed (P = .019). However, changes in SHR, scapular upward rotation, or scapular and humeral internal/external rotation from preoperative to postoperative conditions were not statistically significant. Additionally, a significant correlation was not detected between the preoperative and postoperative mean SHR. Conclusion: rTSA significantly increases scapular posterior tilt postoperatively compared to the preoperative condition. However, significant changes from the preoperative to postoperative conditions were not demonstrated for other kinematic parameters.
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spelling doaj-art-ef677b7b572746eeba81ae22f2ba2d6b2025-08-20T03:34:00ZengElsevierJSES International2666-63832025-07-01941357136410.1016/j.jseint.2025.04.025Do shoulder kinematics change after reverse total shoulder arthroplasty?Itaru Kawashima, MD, PhD0Eric R. Wagner, MD, MS1Joseph J. King, MD2Zaamin B. Hussain, MD, EdM3Sameer R. Khawaja, BS4Jaden C. Hadrick, BS5Krishna N. Chopra, MA6Michael B. Gottschalk, MD7Scott A. Banks, PhD8Thomas W. Wright, MD9Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA; Corresponding author: Itaru Kawashima, MD, PhD, Department of Orthopaedic Surgery and Sports Medicine, University of Florida, 3450 Hull Road, Gainesville, FL 32611, USA.Department of Orthopaedic Surgery, Emory University, Atlanta, GA, USADepartment of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USADepartment of Orthopaedic Surgery, Emory University, Atlanta, GA, USADepartment of Orthopaedic Surgery, Emory University, Atlanta, GA, USADepartment of Orthopaedic Surgery, Emory University, Atlanta, GA, USADepartment of Orthopaedic Surgery, Emory University, Atlanta, GA, USADepartment of Orthopaedic Surgery, Emory University, Atlanta, GA, USADepartment of Mechanical & Aerospace Engineering, University of Florida, Gainesville, FL, USADepartment of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USABackground: Reverse total shoulder arthroplasty (rTSA) is believed to alter shoulder kinematics. However, it remains unclear whether the kinematic changes observed in shoulders following rTSA were present preoperatively or developed as a result of the surgery. Furthermore, the impact of preoperative scapulohumeral rhythm (SHR) on the postoperative SHR after rTSA is also poorly understood. The primary aim of this study was to compare shoulder kinematics before and after rTSA using the 3-dimensional (3D) to 2-dimensional model-image registration with dynamic digital radiography images. The secondary purpose was to evaluate whether preoperative SHR correlates with postoperative SHR after rTSA. Methods: Twenty shoulders in 19 patients that underwent rTSA were included. Dynamic digital radiography images were performed preoperatively and 6 months or later postoperatively to assess shoulder motion during scapular plane abduction. 3D surface models of preoperative scapula and humerus, and postoperative scapula and humerus with implants were created from the preoperative and postoperative computed tomography images. Scapular and humeral kinematics were evaluated using a 3D to 2-dimensional model image registration method. Each kinematics parameter was calculated at 10° increments from 20° to 90° of humeral abduction. The mean SHR was also calculated from the humeral position at side to 90° or to the maximum humeral abduction if it was less than 90°. Linear mixed-effects models for repeated measures were used to compare kinematics at each humeral abduction between preoperative and postoperative conditions. The correlation between the preoperative mean SHR and the postoperative mean SHR was assessed using Pearson's product-moment correlation statistic. Results: A significant postoperative increase in scapular posterior tilt was observed (P = .019). However, changes in SHR, scapular upward rotation, or scapular and humeral internal/external rotation from preoperative to postoperative conditions were not statistically significant. Additionally, a significant correlation was not detected between the preoperative and postoperative mean SHR. Conclusion: rTSA significantly increases scapular posterior tilt postoperatively compared to the preoperative condition. However, significant changes from the preoperative to postoperative conditions were not demonstrated for other kinematic parameters.http://www.sciencedirect.com/science/article/pii/S2666638325001483Reverse total shoulder arthroplastyArthroplastyShoulderScapulohumeral rhythmSHRKinematics
spellingShingle Itaru Kawashima, MD, PhD
Eric R. Wagner, MD, MS
Joseph J. King, MD
Zaamin B. Hussain, MD, EdM
Sameer R. Khawaja, BS
Jaden C. Hadrick, BS
Krishna N. Chopra, MA
Michael B. Gottschalk, MD
Scott A. Banks, PhD
Thomas W. Wright, MD
Do shoulder kinematics change after reverse total shoulder arthroplasty?
JSES International
Reverse total shoulder arthroplasty
Arthroplasty
Shoulder
Scapulohumeral rhythm
SHR
Kinematics
title Do shoulder kinematics change after reverse total shoulder arthroplasty?
title_full Do shoulder kinematics change after reverse total shoulder arthroplasty?
title_fullStr Do shoulder kinematics change after reverse total shoulder arthroplasty?
title_full_unstemmed Do shoulder kinematics change after reverse total shoulder arthroplasty?
title_short Do shoulder kinematics change after reverse total shoulder arthroplasty?
title_sort do shoulder kinematics change after reverse total shoulder arthroplasty
topic Reverse total shoulder arthroplasty
Arthroplasty
Shoulder
Scapulohumeral rhythm
SHR
Kinematics
url http://www.sciencedirect.com/science/article/pii/S2666638325001483
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