Skip to main content
SpringerLink
Log in

What is the best glenoid configuration in onlay reverse shoulder arthroplasty?

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to analyze the effect of different glenoid configurations on arm position and range of motion (ROM) following reverse shoulder arthroplasty (RSA). The hypothesis was that different glenoid configurations would lead to changes in humeral offset, acromio-humeral distance (AHD), ROM, and rotator cuff muscle length.

Methods

Using a three-dimensional (3D) computer model, implantation of an RSA was simulated with a 145° onlay humeral stem combined with five different glenoid configurations which varied in diameter and centre of rotation. Glenoid offset, the AHD, ROM, and muscle length were evaluated for each configuration.

Results

Changing glenoid design led to up to a 10 mm change in offset and a 3 mm change in the AHD. There was 7° of improvement in abduction and flexion between the different glenoid designs. Two of the configurations, the 36 mm centered and the BIO-RSA, had an adduction deficit. In extension and external rotation arm with the arm at side, the eccentric 36 mm glenosphere was the best configuration while the centered 36 mm glenosphere was the worst configuration. The 42 mm glenosphere limited external rotation at 90° of abduction.

Conclusions

Varying the glenosphere configurations leads to ROM and muscle length changes following RSA. With a 145° onlay humeral stem, a 36 eccentric glenosphere theoretically optimizes ROM while limiting scapular notching.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Gerber C, Pennington SD, Nyffeler RW (2009) Reverse total shoulder arthroplasty. J Am Acad Orthop Surg 17:284–295

    Article  PubMed  Google Scholar 

  2. 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 469:2558–2567. https://doi.org/10.1007/s11999-011-1775-4

    Article  PubMed  PubMed Central  Google Scholar 

  3. Gutierrez S, Comiskey CA, Luo ZP, Pupello DR, Frankle MA (2008) Range of impingement-free abduction and adduction deficit after reverse shoulder arthroplasty. Hierarchy of surgical and implant-design-related factors. J Bone Joint Surg Am 90:2606–2615. https://doi.org/10.2106/JBJS.H.00012

    Article  PubMed  Google Scholar 

  4. Lädermann A, Gueorguiev B, Charbonnier C, Stimec BV, Fasel JH, Zderic I, Hagen J, Walch G (2015) Scapular notching on kinematic simulated range of motion after reverse shoulder arthroplasty is not the result of impingement in adduction. Medicine (Baltimore) 94:e1615. https://doi.org/10.1097/MD.0000000000001615

    Article  Google Scholar 

  5. Berhouet J, Garaud P, Favard L (2013) Evaluation of the role of glenosphere design and humeral component retroversion in avoiding scapular notching during reverse shoulder arthroplasty. J Shoulder Elb Surg. https://doi.org/10.1016/j.jse.2013.05.009

  6. Collin P, Liu X, Denard PJ, Gain S, Nowak A, Ladermann A (2017) Standard versus bony increased-offset reverse shoulder arthroplasty: a retrospective comparative cohort study. J Shoulder Elb Surg. https://doi.org/10.1016/j.jse.2017.07.020

  7. Levigne C, Boileau P, Favard L, Garaud P, Mole D, Sirveaux F, Walch G (2008) Scapular notching in reverse shoulder arthroplasty. J Shoulder Elb Surg 17:925–935. https://doi.org/10.1016/j.jse.2008.02.010

    Article  Google Scholar 

  8. 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 469:2512–2520. https://doi.org/10.1007/s11999-010-1695-8

    Article  PubMed  Google Scholar 

  9. Mizuno N, Denard PJ, Raiss P, Walch G (2012) The clinical and radiographical results of reverse total shoulder arthroplasty with eccentric glenosphere. Int Orthop 36:1647–1653. https://doi.org/10.1007/s00264-012-1539-0

    Article  PubMed  PubMed Central  Google Scholar 

  10. Lädermann A, Denard PJ, Boileau P, Farron A, Deransart P, Terrier A, Ston J, Walch G (2015) Effect of humeral stem design on humeral position and range of motion in reverse shoulder arthroplasty. Int Orthop 39:2205–2213. https://doi.org/10.1007/s00264-015-2984-3

    Article  PubMed  Google Scholar 

  11. van Andel CJ, Wolterbeek N, Doorenbosch CA, Veeger DH, Harlaar J (2008) Complete 3D kinematics of upper extremity functional tasks. Gait & Posture 27:120–127. https://doi.org/10.1016/j.gaitpost.2007.03.002

    Article  Google Scholar 

  12. Wu G, Siegler S, Allard P, Kirtley C, Leardini A, Rosenbaum D, Whittle M, D'Lima DD, Cristofolini L, Witte H, Schmid O, Stokes I (2002) ISB recommendation on definitions of joint coordinate system of various joints for the reporting of human joint motion—part I: ankle, hip, and spine. International Society of Biomechanics J Biomech 35:543–548

    PubMed  Google Scholar 

  13. Charbonnier C, Chague S, Ponzoni M, Bernardoni M, Hoffmeyer P, Christofilopoulos P (2014) Sexual activity after total hip arthroplasty: a motion capture study. J Arthroplast 29:640–647. https://doi.org/10.1016/j.arth.2013.07.043

    Article  Google Scholar 

  14. Lädermann A, Edwards TB, Walch G (2014) Arm lengthening after reverse shoulder arthroplasty: a review. Int Orthop 38:991–1000. https://doi.org/10.1007/s00264-013-2175-z

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  16. 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 Elb Surg 21:336–341. https://doi.org/10.1016/j.jse.2011.04.020

    Article  Google Scholar 

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

    Article  Google Scholar 

  18. Greiner S, Schmidt C, Herrmann S, Pauly S, Perka C (2015) Clinical performance of lateralized versus non-lateralized reverse shoulder arthroplasty: a prospective randomized study. J Shoulder Elb Surg 24:1397–1404. https://doi.org/10.1016/j.jse.2015.05.041

    Article  Google Scholar 

  19. Athwal GS, MacDermid JC, Reddy KM, Marsh JP, Faber KJ, Drosdowech D (2015) Does bony increased-offset reverse shoulder arthroplasty decrease scapular notching? J Shoulder Elb Surg 24:468–473. https://doi.org/10.1016/j.jse.2014.08.015

    Article  Google Scholar 

  20. Erickson BJ, Harris JD, Romeo AA (2016) The effect of humeral inclination on range of motion in reverse total shoulder arthroplasty: a systematic review. Am J Orthop 45:E174–E179

    PubMed  Google Scholar 

  21. Hettrich CM, Permeswaran VN, Goetz JE, Anderson DD (2015) Mechanical tradeoffs associated with glenosphere lateralization in reverse shoulder arthroplasty. J Shoulder Elb Surg 24:1774–1781. https://doi.org/10.1016/j.jse.2015.06.011

    Article  Google Scholar 

  22. 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 Elb Surg 15:527–540. https://doi.org/10.1016/j.jse.2006.01.003

    Article  Google Scholar 

  23. Blix M (1891) Die lange und dle spannung des muskels. Skand Arch Physiol 3:295–318

    Article  Google Scholar 

  24. Halder AM, O'Driscoll SW, Heers G, Mura N, Zobitz ME, An KN, Kreusch-Brinker R (2002) Biomechanical comparison of effects of supraspinatus tendon detachments, tendon defects, and muscle retractions. J Bone Joint Surg Am 84-A:780–785

    Article  PubMed  CAS  Google Scholar 

  25. Lädermann A, Denard PJ, Tirefort J, Collin P, Nowak A, Schwitzguebel AJ (2017) Subscapularis- and deltoid-sparing vs traditional deltopectoral approach in reverse shoulder arthroplasty: a prospective case–control study. J Orthop Surg Res 12:112. https://doi.org/10.1186/s13018-017-0617-9

    Article  PubMed  PubMed Central  Google Scholar 

  26. Lädermann A, Lo EY, Schwitzguebel AJ, Yates E (2016) Subscapularis and deltoid preserving anterior approach for reverse shoulder arthroplasty. Orthopaedics & Traumatology, Surgery & Research: OTSR 102:905–908. https://doi.org/10.1016/j.otsr.2016.06.005

    Article  Google Scholar 

  27. Moor BK, Bouaicha S, Rothenfluh DA, Sukthankar A, Gerber C (2013) Is there an association between the individual anatomy of the scapula and the development of rotator cuff tears or osteoarthritis of the glenohumeral joint?: a radiological study of the critical shoulder angle. The Bone & Joint Journal 95-B:935–941. https://doi.org/10.1302/0301-620X.95B7.31028

    Article  CAS  Google Scholar 

  28. Berhouet J, Garaud P, Slimane M, Nicot J, Banah J, Waynberger E, Favard L (2014) Effect of scapular pillar anatomy on scapular impingement in adduction and rotation after reverse shoulder arthroplasty. Orthopaedics & Traumatology, Surgery & Research: OTSR. https://doi.org/10.1016/j.otsr.2014.03.021

Download references

Author information

Authors and Affiliations

  1. Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Rue J.-D. Maillard 3, 1217, Meyrin, Switzerland

    Alexandre Lädermann

  2. Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1211, Geneva 4, Switzerland

    Alexandre Lädermann

  3. Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland

    Alexandre Lädermann

  4. Southern Oregon Orthopedics, Medford, OR, USA

    Patrick J. Denard

  5. Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA

    Patrick J. Denard

  6. Department of Orthopaedic Surgery and Sports Traumatology, Hôpital de L’ Archet–University of Nice Sophia–Antipolis, 151, Route de St Antoine de Ginestière, 06202, Nice, France

    Pascal Boileau

  7. Division of Orthopaedics and Trauma Surgery, Department of Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

    Alain Farron

  8. Imascap SAS, Brest, France

    Pierric Deransart

  9. Department of Orthopaedics, Shoulder Unit, Santy Orthopaedic Center and Jean Mermoz Hospital, Lyon, France

    Gilles Walch

Authors
  1. Alexandre Lädermann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Patrick J. Denard
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pascal Boileau
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alain Farron
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pierric Deransart
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gilles Walch
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alexandre Lädermann.

Ethics declarations

Conflicts of interest

Two authors (G.W., P.B.) of this study received royalties from the Wright Medical Group NV. One author (P.J.D.) is a paid consultant for Arthrex. One author (P.D.) of this study held stock from the Wright Medical Group NV.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lädermann, A., Denard, P.J., Boileau, P. et al. What is the best glenoid configuration in onlay reverse shoulder arthroplasty?. International Orthopaedics (SICOT) 42, 1339–1346 (2018). https://doi.org/10.1007/s00264-018-3850-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-018-3850-x

Keywords

Search

Navigation