These authors sought to determine the effect of humeral articular component positioning on changes in patient-reported outcomes after anatomic total shoulder arthroplasty in 95 patients from one of two high-volume referral centers with a mean followup of 4.3 years. The study included patients with (1) a preoperative and postoperative radiograph demonstrating a perfect or nearly perfect profile of the humerus and implant and (2) clinical scores preoperatively and at greater than 2 years postoperatively.
The distance and direction from the ideal center of rotation to the reconstructed center of rotation was measured.
The COR shift was >2 mm in 62% of patients and >4 mm 15%. The Simple Shoulder Test scores improved from 3.4 to 9.8.
On multivariate analysis, there were no significant associations between any change in measured prosthetic radiographic parameters and changes in the visual analog scale, Simple Shoulder Test, or ASES scores (P > .05).
Comment: What this study actually shows is that the expert surgeons from these high volume centers were able to consistently place the humeral component in a functional position. This study must not be interpreted as showing that the positioning of the humeral component is unimportant. In fact, high positioning of the humeral component is an important cause of 'rocking horse' loosening of the humeral component as shown below
Comment: What this study actually shows is that the expert surgeons from these high volume centers were able to consistently place the humeral component in a functional position. This study must not be interpreted as showing that the positioning of the humeral component is unimportant. In fact, high positioning of the humeral component is an important cause of 'rocking horse' loosening of the humeral component as shown below
High positioning often arises from the use of a humeral body that is too large to completely seat in the humeral canal.
An interesting aspect of this study is that while 37 of the glenoids in this study were type B, the good results were achieved without the use of a posteriorly augmented glenoid component.
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How you can support progress in shoulder surgery
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Use the "Search" box to the right to find other topics of interest to you.
How you can support progress in shoulder surgery
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
