Reverse shoulder arthroplasty leads to significant biomechanical changes in the remaining rotator cuff

J Orthop Surg Res. 2011 Aug 16:6:42. doi: 10.1186/1749-799X-6-42.

Abstract

Objective: After reverse shoulder arthroplasty (RSA) external and internal rotation will often remain restricted. A postoperative alteration of the biomechanics in the remaining cuff is discussed as a contributing factor to these functional deficits.

Methods: In this study, muscle moment arms as well as origin-to-insertion distance (OID) were calculated using three-dimensional models of the shoulder derived from CT scans of seven cadaveric specimens.

Results: Moment arms for humeral rotation are significantly smaller for the cranial segments of SSC and all segments of TMIN in abduction angles of 30 degrees and above (p ≤ 0.05). Abduction moment arms were significantly decreased for all segments (p ≤ 0.002). OID was significantly smaller for all muscles at the 15 degree position (p ≤ 0.005), apart from the cranial SSC segment.

Conclusions: Reduced rotational moment arms in conjunction with the decrease of OID may be a possible explanation for the clinically observed impaired external and internal rotation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty / instrumentation
  • Arthroplasty / methods*
  • Biomechanical Phenomena
  • Cadaver
  • Humans
  • Middle Aged
  • Prostheses and Implants
  • Prosthesis Design
  • Range of Motion, Articular*
  • Rotator Cuff* / diagnostic imaging
  • Shoulder Joint / diagnostic imaging
  • Shoulder Joint / surgery*
  • Tomography, X-Ray Computed