Acromion and Scapular Spine Fractures Following Reverse Total Shoulder Arthroplasty.

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Abstract

[Indexed for MEDLINE] 13. Int Orthop. 2020 Dec;44(12):2691-2699. doi: 10.1007/s00264-020-04756-x. Epub 2020 Aug 15. Shoulder proprioception following reverse total shoulder arthroplasty. Walecka J(1)(2), Lubiatowski P(3)(4), Consigliere P(5), Atoun E(5), Levy O(5). Author information: (1)Sport Trauma and Biomechancis Unit, Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences in Poznan, ul Gorecka 30, 60-201, Poznan, Polska. joanna.walecka@rehasport.pl. (2)Rehasport Clinic, ul. Górecka 30, 60-201, Poznań, Poland. joanna.walecka@rehasport.pl. (3)Sport Trauma and Biomechancis Unit, Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences in Poznan, ul Gorecka 30, 60-201, Poznan, Polska. (4)Rehasport Clinic, ul. Górecka 30, 60-201, Poznań, Poland. (5)Reading Shoulder Unit, Royal Berkshire Hospital and Berkshire Independent Hospital, Reading, Berkshire, UK. Joint replacement affects the proprioception, as shown in knees, elbows, and shoulder studies. AIM: The aim was to evaluate shoulder joint position sense (JPS) following reverse total shoulder arthroplasty (rTSA) for patients with cuff arthropathy. METHODS: Twenty-nine patients that underwent unilateral rTSA (19 females, 10 males) and 31 healthy volunteers evaluated for JPS of shoulder using a dedicated high accuracy electronic goniometer. Error of active reproduction of joint position (EARJP) was assessed at the following reference positions: 30°, 60°, 90°, and 120° for forward flexion and abduction and 15°, 30°, and 45° for internal and external rotation in rTSA, contralateral non-operated, and control shoulders. RESULTS: Results of EPRJP for rTSA, contralateral, and control (respectively) are as follows:Forward flexion: 30° = (8.0 ± 5.7, 9.8 ± 6.1, and 4.9 ± 3.0), 60° = (5.0 ± 2.8, 5.9 ± 2.7, and 5.1 ± 3.2), 90° = (3.1 ± 1.6, 5.5 ± 2.6, and 3.2 ± 1.4), and 120° = (3.4 ± 2.1, 5.6 ± 4.0, and 3.5 ± 1.7)Abduction: 30° = (5.2 ± 2.5, 9.1 ± 6.1, and 4.6 ± 2.3), 60° = (5.2 ± 3.6, 6.6 ± 4.1, and 5.3 ± 3.1), 90° = (3.8 ± 2.0; 7.4 ± 5.5, and 4.1 ± 1.9), and 120° = (5.3 ± 2.9, 7.7 ± 5.3, and 4.2 ± 1.9)Internal rotation: 15° = (4.3 ± 3.1, 6.2 ± 4.4, and 2.8 ± 1.2), 30° = (3.2 ± 1.9, 4.5 ± 2.3, and 3.3 ± 1.4), and 45° = (3.5 ± 2.0, 4.1 ± 1.8, and 2.8 ± 1.0)External rotation: 15° = (3.0 ± 1.7, 4.2 ± 2.2, and 3.6 ± 1.4) and 30° = (3.1 ± 1.5, 3.8 ± 2.6, and 3.4 ± 1.6)The results showed significantly better JPS (lower EPRJP) in shoulders following rTSA and normal control shoulders comparing with the patient's contralateral shoulder. The explanation can be that rTSA improves joint kinematics and stability, which allows better muscular performance and proprioception feedback. CONCLUSION: Shoulders following rTSA show JPS superior to non-operated contralateral shoulders and comparable with healthy population shoulders. It seems that rTSA restores shoulder proprioception. DOI: 10.1007/s00264-020-04756-x PMCID: PMC7679309