Top

International Orthopaedics

Published in:

01-05-2014 | Review article

Arm lengthening after reverse shoulder arthroplasty: a review

Authors: Alexandre Lädermann, Tom Bradley Edwards, Gilles Walch

Published in: International Orthopaedics | Issue 5/2014

Abstract

Purpose

The purpose of this review is to provide a better understanding of biomechanical changes induced by reverse shoulder arthroplasty (RSA), discuss the different techniques of radiographic assessment of upper limb lengthening after RSA and determine the ideal soft tissue tension that provides the best functional outcome without increasing the risk of complications.

Methods

Inclusion criteria were articles in which the primary interest was the technique of measuring upper-extremity lengthening after complications related to lengthening and its role in postoperative function; those written in English, French or German; and those that provided evidence levels I–IV relevant to search terms.

Results

Seven articles met our inclusion criteria. Postoperatively, changes in humeral length varied from minus five to five millimetres, and changes in upper-extremity length varied from 15 mm to 27 mm. The acromiohumeral distance averaged 23 mm. Humeral and arm shortening increased the risk of dislocation and led to poor anterior active elevation. The type of surgical approach did not play a role in postoperative function. Subclinical neurological lesions were frequent.

Conclusions

Studies in this systematic review indicate that deltoid tensioning by restoring humeral length and increasing the acromiohumeral distance is critical for adequate postoperative function and to prevent dislocation. Excessive arm lengthening should be avoided, with zero to two centimetres of lengthening being a reasonable goal to avoid postoperative neurological impairment.

Baulot E, Sirveaux F, Boileau P (2011) Grammont’s idea: the story of Paul Grammont’s functional surgery concept and the development of the reverse principle. Clin Orthop Relat Res 469(9):2425–2431. doi:10.1007/s11999-010-1757-y PubMedCentralPubMedCrossRef

Meyer DC, Farshad M, Amacker NA, Gerber C, Wieser K (2012) Quantitative analysis of muscle and tendon retraction in chronic rotator cuff tears. Am J Sports Med 40(3):606–610. doi:10.1177/0363546511429778 PubMedCrossRef

Williams MD, Lädermann A, Melis B, Barthelemy R, Walch G (2009) Fatty infiltration of the supraspinatus: a reliability study. J Shoulder Elbow Surg 18(4):581–587. doi:10.1016/j.jse.2008.12.014 PubMedCrossRef

Zanetti M, Gerber C, Hodler J (1998) Quantitative assessment of the muscles of the rotator cuff with magnetic resonance imaging. Investig Radiol 33(3):163–170CrossRef

Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1994) Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res 304:78–83PubMed

Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1995) Fatty infiltration of disrupted rotator cuff muscles. Rev Rhum 62(6):415–422

Goutallier D, Postel JM, Lavau L, Bernageau J (1999) Impact of fatty degeneration of the suparspinatus and infraspinatus msucles on the prognosis of surgical repair of the rotator cuff. Rev Chir Orthop Reparatrice Appar Mot 85(7):668–676PubMed

Kim HM, Galatz LM, Lim C, Havlioglu N, Thomopoulos S (2012) The effect of tear size and nerve injury on rotator cuff muscle fatty degeneration in a rodent animal model. J Shoulder Elbow Surg 21(7):847–858. doi:10.1016/j.jse.2011.05.004 PubMedCentralPubMedCrossRef

Boileau P, Baque F, Valerio L, Ahrens P, Chuinard C, Trojani C (2007) Isolated arthroscopic biceps tenotomy or tenodesis improves symptoms in patients with massive irreparable rotator cuff tears. J Bone Joint Surg Am 89(4):747–757. doi:10.2106/JBJS.E.01097 PubMedCrossRef

10.

Lädermann A, Collin P, Walch G (2012) Correlation of the involved compartments of massive rotator cuff tear and loss of active shoulder range of motion. Knee Surg Sports Traumatol Arthrosc 20(Suppl 1):S1–S3. doi: 10.1007/s00167-012-1934-5

11.

Denard PJ, Jiwani AZ, Lädermann A, Burkhart SS (2012) Long-term outcome of a consecutive series of subscapularis tendon tears repaired arthroscopically. Arthroscopy. doi:10.1016/j.arthro.2012.02.031

12.

Denard PJ, Jiwani AZ, Lädermann A, Burkhart SS (2012) Long-term outcome of arthroscopic massive rotator cuff repair: the importance of double-row fixation. Arthroscopy 28(7):909–915. doi:10.1016/j.arthro.2011.12.007 PubMedCrossRef

13.

Denard PJ, Lädermann A, Burkhart SS (2011) Arthroscopic management of subscapularis tears. Sports Med Arthrosc Rev 19(4):333–341. doi:10.1097/JSA.0b013e31822d41c6 CrossRef

14.

Lädermann A, Denard PJ, Burkhart SS (2012) Revision arthroscopic rotator cuff repair: systematic review and authors’ preferred surgical technique. Arthroscopy 28(8):1160–1169. doi:10.1016/j.arthro.2012.01.006 PubMedCrossRef

15.

Lädermann A, Denard PJ, Burkhart SS (2011) Midterm outcome of arthroscopic revision repair of massive and nonmassive rotator cuff tears. Arthroscopy 27(12):1620–1627. doi:10.1016/j.arthro.2011.08.290 PubMedCrossRef

16.

Zumstein MA, Jost B, Hempel J, Hodler J, Gerber C (2008) The clinical and structural long-term results of open repair of massive tears of the rotator cuff. J Bone Joint Surg Am 90(11):2423–2431. doi:10.2106/JBJS.G.00677 PubMedCrossRef

17.

Denard PJ, Lädermann A, Jiwani AZ, Burkhart SS (2012) Functional outcome after arthroscopic repair of massive rotator cuff tears in individuals with pseudoparalysis. Arthroscopy 28(9):1214–1219. doi:10.1016/j.arthro.2012.02.026 PubMedCrossRef

18.

Grammont PM, Trouilloud P, Latfay J, Deries X (1987) Etude et réalisation d’une nouvelle prothèse d’épaule. Rhumatologie 39:407–418

19.

Boileau P, Watkinson DJ, Hatzidakis AM, Balg F (2005) Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg 14(1 Suppl S):147S–161S. doi:10.1016/j.jse.2004.10.006 PubMedCrossRef

20.

Gagey O, Hue E (2000) Mechanics of the deltoid muscle. A new approach. Clin Orthop Relat Res 375:250–257PubMedCrossRef

21.

Boileau P, Watkinson D, Hatzidakis AM, Hovorka I (2006) Neer Award 2005: the Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J Shoulder Elbow Surg 15(5):527–540. doi:10.1016/j.jse.2006.01.003 PubMedCrossRef

22.

Scarlat MM (2013) Complications with reverse total shoulder arthroplasty and recent evolutions. Int Orthop 37(5):843–851. doi:10.1007/s00264-013-1832-6 PubMedCrossRef

23.

Sirveaux F, Favard L, Oudet D, Huguet D, Lautman S (2001) Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive and non repairable cuff rupture. In: Walch G, Boileau P, Molé D (eds) 2000 shoulder prostheses: Two to ten year follow-up. Sauramps Medical, Montpellier, pp 247–252

24.

Valenti PH, Boutens D, Nerot C (2001) Delta 3 reversed prosthesis for osteoarthritis with massive rotator cuff tear: Long term results (> 5 years). In: Walch G, Boileau P, Molé D (eds) 2000 shoulder prostheses: Two to ten year follow-up. Sauramps Medical, Montpellier, pp 253–259

25.

Lädermann A, Lubbeke A, Collin P, Edwards TB, Sirveaux F, Walch G (2011) Influence of surgical approach on functional outcome in reverse shoulder arthroplasty. Orthop Traumatol Surg Res 97(6):579–582. doi:10.1016/j.otsr.2011.04.008 PubMed

26.

Lädermann A, Lubbeke A, Mélis B, Stern R, Christofilopoulos P, Bacle G, Walch G (2011) Prevalence of neurologic lesions after total shoulder arthroplasty. J Bone Joint Surg Am 93(14):1288–1293. doi:10.2106/JBJS.J.00369 PubMed

27.

Lädermann A, Walch G, Lubbeke A, Drake GN, Mélis B, Bacle G, Collin P, Edwards TB, Sirveaux F (2012) Influence of arm lengthening in reverse shoulder arthroplasty. J Shoulder Elbow Surg 21(3):336–341. doi:10.1016/j.jse.2011.04.020 PubMed

28.

Lädermann A, Williams MD, Mélis B, Hoffmeyer P, Walch G (2009) Objective evaluation of lengthening in reverse shoulder arthroplasty. J Shoulder Elbow Surg 18(4):588–595. doi:10.1016/j.jse.2009.03.012 PubMed

29.

Jobin CM, Brown GD, Bahu MJ, Gardner TR, Bigliani LU, Levine WN, Ahmad CS (2012) Reverse total shoulder arthroplasty for cuff tear arthropathy: the clinical effect of deltoid lengthening and centre of rotation medialization. J Shoulder Elbow Surg 21(10):1269–1277. doi:10.1016/j.jse.2011.08.049 PubMed

30.

Renaud P, Wahab H, Bontoux L, Dauty M, Richard I, Bregeon C (2001) Total inverted shoulder prosthesis and rotator cuff insufficiency: evaluation and determination of anatomical parameters predictive of good functional outcome in 21 shoulders. Ann Readapt Med Phys: Rev Sci Soc Fr Reeducation Fonctionnelle Readaptat Med Phys 44(5):273–280

31.

Greiner SH, Back DA, Herrmann S, Perka C, Asbach P (2010) Degenerative changes of the deltoid muscle have impact on clinical outcome after reversed total shoulder arthroplasty. Arch Orthop Trauma Surg 130(2):177–183. doi:10.1007/s00402-009-1001-y PubMed

32.

De Biase CF, Ziveri G, Delcogliano M, de Caro F, Gumina S, Borroni M, Castagna A, Postacchini R (2013) The use of an eccentric glenosphere compared with a concentric glenosphere in reverse total shoulder arthroplasty: two-year minimum follow-up results. Int Orthop 37(10):1949–1955. doi:10.1007/s00264-013-1947-9 PubMed

33.

Levigne C, Garret J, Boileau P, Alami G, Favard L, Walch G (2011) Scapular notching in reverse shoulder arthroplasty: is it important to avoid it and how? Clin Orthop Relat Res 469(9):2512–2520. doi:10.1007/s11999-010-1695-8 PubMedCentralPubMed

34.

Mélis B, DeFranco M, Lädermann A, Mole D, Favard L, Nerot C, Maynou C, Walch G (2011) An evaluation of the radiological changes around the Grammont reverse geometry shoulder arthroplasty after eight to 12 years. J Bone Joint Surg Br 93(9):1240–1246. doi:10.1302/0301-620X.93B9.25926 PubMed

35.

Mizuno N, Denard PJ, Raiss P, Walch G (2013) Reverse total shoulder arthroplasty for primary glenohumeral osteoarthritis in patients with a biconcave glenoid. J Bone Joint Surg Am 95(14):1297–1304. doi:10.2106/JBJS.L.00820 PubMed

36.

Nyffeler RW, Werner CM, Gerber C (2005) Biomechanical relevance of glenoid component positioning in the reverse Delta III total shoulder prosthesis. J Shoulder Elbow Surg 14(5):524–528. doi:10.1016/j.jse.2004.09.010 PubMed

37.

Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Mole D (2004) Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Joint Surg Br 86(3):388–395PubMed

38.

De Wilde LF, Audenaert EA, Berghs BM (2004) Shoulder prostheses treating cuff tear arthropathy: a comparative biomechanical study. J Orthop Res 22(6):1222–1230. doi:10.1016/j.orthres.2004.03.010 PubMed

39.

Dedy NJ, Stangenberg M, Liem D, Hurschler C, Simmen B, Riner M, Marquardt B, Steinbeck J (2011) Effect of posterior offset humeral components on range of motion in reverse shoulder arthroplasty. Int Orthop 35(4):549–554. doi:10.1007/s00264-010-1079-4 PubMedCentralPubMed

40.

Ortmaier R, Resch H, Hitzl W, Mayer M, Blocher M, Vasvary I, Mattiassich G, Stundner O, Tauber M (2013) Reverse shoulder arthroplasty combined with latissimus dorsi transfer using the bone-chip technique. Int Orthop. doi:10.1007/s00264-013-2139-3 PubMedCentral

41.

Wall B, Nove-Josserand L, O’Connor DP, Edwards TB, Walch G (2007) Reverse total shoulder arthroplasty: a review of results according to etiology. J Bone Joint Surg Am 89(7):1476–1485. doi:10.2106/JBJS.F.00666 PubMed

42.

Lädermann A, Walch G, Denard PJ, Collin P, Sirveaux F, Favard L, Edwards TB, Kherad O, Boileau P (2013) Reverse shoulder arthroplasty in patients with pre-operative impairment of the deltoid muscle. Bone Joint J 95-B(8):1106–1113. doi:10.1302/0301-620X.95B8.31173 PubMed

43.

Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164PubMed

44.

Schwartz DG, Kang SH, Lynch TS, Edwards S, Nuber G, Zhang LQ, Saltzman M (2012) The anterior deltoid’s importance in reverse shoulder arthroplasty: a cadaveric biomechanical study. J Shoulder Elbow Surg. doi:10.1016/j.jse.2012.02.002 PubMed

45.

Germann G, Wind G, Harth A (1999) The DASH(Disability of Arm-Shoulder-Hand) Questionnaire–a new instrument for evaluating upper extremity treatment outcome. Handchir Mikrochir Plast Chir: Organ Deutschsprachigen Arbeitsgemeinschaft Handchir: Organ Deutschsprachigen Arbeitsgemeinschaft Mikrochir Peripheren Nerven Gefasse 31(3):149–152. doi:10.1055/s-1999-13902

46.

Michener LA, McClure PW, Sennett BJ (2002) American shoulder and elbow surgeons standardized shoulder assessment form, patient self-report section: reliability, validity, and responsiveness. J Shoulder Elbow Surg 11(6):587–594. doi:10.1067/mse.2002.127096 PubMed

47.

Cazeneuve JF, Cristofari DJ (2006) Grammont reversed prosthesis for acute complex fracture of the proximal humerus in an elderly population with 5 to 12 years follow-up. Rev Chir Orthop Reparatrice Appar Mot 92(6):543–548PubMed

48.

Cuff D, Pupello D, Virani N, Levy J, Frankle M (2008) Reverse shoulder arthroplasty for the treatment of rotator cuff deficiency. J Bone Joint Surg Am 90(6):1244–1251. doi:10.2106/JBJS.G.00775 PubMed

49.

rCuff DJ, Virani NA, Levy J, Frankle MA, Derasari A, Hines B, Pupello DR, Cancio M, Mighell M (2008) The treatment of deep shoulder infection and glenohumeral instability with debridement, reverse shoulder arthroplasty and postoperative antibiotics. J Bone Joint Surg Br 90(3):336–342. doi:10.1302/0301-620X.90B3.19408

50.

De Wilde L, Sys G, Julien Y, Van Ovost E, Poffyn B, Trouilloud P (2003) The reversed Delta shoulder prosthesis in reconstruction of the proximal humerus after tumour resection. Acta Orthop Belg 69(6):495–500PubMed

51.

Gohlke F, Rolf O (2007) Revision of failed fracture hemiarthroplasties to reverse total shoulder prosthesis through the transhumeral approach : method incorporating a pectoralis-major-pedicled bone window. Oper Orthop Traumatol 19(2):185–208. doi:10.1007/s00064-007-1202-x PubMed

52.

Levy J, Frankle M, Mighell M, Pupello D (2007) The use of the reverse shoulder prosthesis for the treatment of failed hemiarthroplasty for proximal humeral fracture. J Bone Joint Surg Am 89(2):292–300. doi:10.2106/JBJS.E.01310 PubMed

53.

Werner CM, Steinmann PA, Gilbart M, Gerber C (2005) Treatment of painful pseudoparesis due to irreparable rotator cuff dysfunction with the Delta III reverse-ball-and-socket total shoulder prosthesis. J Bone Joint Surg Am 87(7):1476–1486. doi:10.2106/JBJS.D.02342 PubMed

54.

Farshad M, Gerber C (2010) Reverse total shoulder arthroplasty-from the most to the least common complication. Int Orthop 34(8):1075–1082. doi:10.1007/s00264-010-1125-2 PubMedCentralPubMed

55.

Edwards TB, Williams MD, Labriola JE, Elkousy HA, Gartsman GM, O’Connor DP (2009) Subscapularis insufficiency and the risk of shoulder dislocation after reverse shoulder arthroplasty. J Shoulder Elbow Surg 18(6):892–896. doi:10.1016/j.jse.2008.12.013 PubMed

56.

Zumstein MA, Pinedo M, Old J, Boileau P (2011) Problems, complications, reoperations, and revisions in reverse total shoulder arthroplasty: a systematic review. J Shoulder Elbow Surg 20(1):146–157. doi:10.1016/j.jse.2010.08.001 PubMed

57.

Mottier F, Wall B, Nove-Josserand L, Galoisy Guibal L, Walch G (2007) Reverse prosthesis and os acromiale or acromion stress fracture. Rev Chir Orthop Reparatrice Appar Mot 93(2):133–141PubMed

58.

Walch G, Mottier F, Wall B, Boileau P, Mole D, Favard L (2009) Acromial insufficiency in reverse shoulder arthroplasties. J Shoulder Elbow Surg 18(3):495–502. doi:10.1016/j.jse.2008.12.002 PubMed

59.

Molé D, Favard L (2007) Excentreed scapulohumeral osteoarthritis. Rev Chir Orthop Reparatrice Appar Mot 93(6 Suppl):37–94PubMed

60.

Crosby LA, Hamilton A, Twiss T (2011) Scapula fractures after reverse total shoulder arthroplasty: classification and treatment. Clin Orthop Relat Res 469(9):2544–2549. doi:10.1007/s11999-011-1881-3 PubMedCentralPubMed

61.

Otto RJ, Virani NA, Levy JC, Nigro PT, Cuff DJ, Frankle MA (2013) Scapular fractures after reverse shoulder arthroplasty: evaluation of risk factors and the reliability of a proposed classification. J Shoulder Elbow Surg. doi:10.1016/j.jse.2013.02.007

62.

Boardman ND 3rd, Cofield RH (1999) Neurologic complications of shoulder surgery. Clin Orthop Relat Res 368:44–53PubMed

63.

Bohsali KI, Wirth MA, Rockwood CA Jr (2006) Complications of total shoulder arthroplasty. J Bone Joint Surg Am 88(10):2279–2292. doi:10.2106/JBJS.F.00125 PubMed

64.

Lynch NM, Cofield RH, Silbert PL, Hermann RC (1996) Neurologic complications after total shoulder arthroplasty. J Shoulder Elbow Surg 5(1):53–61PubMed

65.

Plausinis D, Kwon YW, Zuckerman JD (2005) Complications of humeral head replacement for proximal humeral fractures. Instr Course Lect 54:371–380PubMed

66.

Aldinger PR, Raiss P, Rickert M, Loew M (2010) Complications in shoulder arthroplasty: an analysis of 485 cases. Int Orthop 34(4):517–524. doi:10.1007/s00264-009-0780-7 PubMedCentralPubMed

67.

Flury MP, Frey P, Goldhahn J, Schwyzer HK, Simmen BR (2011) Reverse shoulder arthroplasty as a salvage procedure for failed conventional shoulder replacement due to cuff failure–midterm results. Int Orthop 35(1):53–60. doi:10.1007/s00264-010-0990-z PubMedCentralPubMed

68.

Ortmaier R, Resch H, Matis N, Blocher M, Auffarth A, Mayer M, Hitzl W, Tauber M (2013) Reverse shoulder arthroplasty in revision of failed shoulder arthroplasty-outcome and follow-up. Int Orthop 37(1):67–75. doi:10.1007/s00264-012-1742-z PubMedCentralPubMed

69.

Valenti P, Katz D (2005) Comment implanter une prothèse inversée? Maîtrise Orthopédique. http://www.maitrise-orthop.com/viewPage.do?id=796

70.

Phipatanakul W, Norris T (2009) Complications and treatment of reverse shoulder prosthesis. In: Dines D, Williams G, Laurencin C (eds) Arthritis and arthroplasty: The shoulder. vol arthritis and arthroplasty. Saunders, Philadelphia

71.

Boileau P, Moineau G, Roussanne Y, O’Shea K (2011) Bony increased-offset reversed shoulder arthroplasty: minimizing scapular impingement while maximizing glenoid fixation. Clin Orthop Relat Res 469(9):2558–2567. doi:10.1007/s11999-011-1775-4 PubMedCentralPubMed

72.

Walker M, Brooks J, Willis M, Frankle M (2011) How reverse shoulder arthroplasty works. Clin Orthop Relat Res 469(9):2440–2451. doi:10.1007/s11999-011-1892-0 PubMedCentralPubMed

73.

Nagda SH, Rogers KJ, Sestokas AK, Getz CL, Ramsey ML, Glaser DL, Williams GR Jr (2007) Neer Award 2005: peripheral nerve function during shoulder arthroplasty using intraoperative nerve monitoring. J Shoulder Elbow Surg 16(3 Suppl):S2–S8. doi:10.1016/j.jse.2006.01.016 PubMed

Title: Arm lengthening after reverse shoulder arthroplasty: a review
Authors: Alexandre Lädermann
Tom Bradley Edwards
Gilles Walch
Publication date: 01-05-2014
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 5/2014
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-013-2175-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Arm lengthening after reverse shoulder arthroplasty: a review

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2014

Comment on Conteduca et al.: Patient-specific instruments in total knee arthroplasty

Implementing a clinical pathway for hip fractures; effects on hospital length of stay and complication rates in five hundred and twenty six patients

Lower recurrence rate in chondroblastoma using extended curettage and cryosurgery

Systematic review and meta-analysis of the additional benefit of local prophylactic antibiotic therapy for infection rates in open tibia fractures treated with intramedullary nailing

Effect of tibial drill-guide angle on the mechanical environment at bone tunnel aperture after anatomic single-bundle anterior cruciate ligament reconstruction

The necessity of pharmacological prophylaxis against venous thromboembolism in major joint arthroplasty