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Influence of Arm Lengthening in Reverse Shoulder Arthroplasty

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Reverse Shoulder Arthroplasty

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Abstract

Adequate deltoid tension obtained through restoration of humeral and arm length is one of the keys for postoperative function and prevention of instability following reverse shoulder arthroplasty (RSA). With a classic Grammont prosthesis, postoperative humeral lengthening is approximately 2 mm and arm lengthening is approximately 24 mm. Humeral and arm lengthening have been correlated with stability and improvement in active anterior elevation, whereas shortening of these variables leads to an increased risk of dislocation and poor active anterior elevation, respectively. Subclinical neurologic lesions are a frequent consequence of lengthening with a drastically increasing prevalence above 40 mm of arm lengthening. Therefore, arm lengthening should be controlled with 0–2 cm being a reasonable goal to avoid postoperative neurological impairment. Preoperative planning is mandatory in revision cases. However, current conventional radiographic preoperative planning techniques are limited.

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Authors and Affiliations

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

    Alexandre Lädermann

  2. Faculty of Medicine, University of Geneva, Geneva, Switzerland

    Alexandre Lädermann

  3. Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland

    Alexandre Lädermann

  4. Southern Oregon Orthopedics, 2780 E. Barnett Rd, Medford, OR, 97504, USA

    Patrick J. Denard

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

    Patrick J. Denard

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  1. Alexandre Lädermann
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Correspondence to Alexandre Lädermann .

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Editors and Affiliations

  1. Florida Orthopedic Institute, Tampa, Florida, USA

    Mark Frankle

  2. Foundation for Orthopedic Research and Education, Tampa, Florida, USA

    Scott Marberry

  3. Foundation for Orthopedic Research and Education, Tampa, Florida, USA

    Derek Pupello

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Lädermann, A., Denard, P.J. (2016). Influence of Arm Lengthening in Reverse Shoulder Arthroplasty. In: Frankle, M., Marberry, S., Pupello, D. (eds) Reverse Shoulder Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-319-20840-4_27

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