How does reverse shoulder replacement change the range of motion in activities of daily living in patients with cuff tear arthropathy? A prospective optical 3D motion analysis study

作者：Maier Michael W^*; Caspers Mira; Zeifang Felix; Dreher Thomas; Klotz Matthias C; Wolf Sebastian I; Kasten Philip

来源：Archives of Orthopaedic and Trauma Surgery, 2014, 134(8): 1065-1071.

DOI：10.1007/s00402-014-2015-7

• Reverse shoulder arthroplasty
• Outcome
• Cuff tear arthropathy
• 3D video analysis
• Marker-based system
• Upper extremity
• Biomechanic model

Reverse total shoulder arthroplasty (RSA) can improve function in cuff tear arthropathy (CTA) shoulders, but limited exact data are available about the maximum values in 3D motion analysis, and as to how improvements translate into the normal range of motion (ROM) in activities of daily living (ADLs).
This study included nine consecutive patients (n = 9) who received RSA for CTA without muscle transfers. We measured shoulder movement by a novel 3D motion analysis using the Heidelberg upper extremity model (HUX) which can eliminate compensatory movements of the scapula, and the trunk. The measurement included active maximum values, and four ADLs.
Comparing the pre- to the 1-year postoperative status, RSA was associated with a significant increase in the mean maximum values for active flexion of about 43A degrees (SD +/- A 31) from 66A degrees to 109A degrees (p = 0.001), for active abduction of about 37A degrees (SD +/- A 26) from 57A degrees to 94A degrees (p = 0.001), and for the active adduction of about 28A degrees (SD +/- A 10) from 5A degrees to 33A degrees (p = 0.002). Comparing the preoperative to the postoperative ROM in the ADLs in flexion/extension, ROM improved significantly in all ADLs, in abduction/adduction in three of four ADLs. No significant changes were observed in internal/external rotation in any ADLs.
RSA improves the active maximum ROM for flexion, abduction, and adduction. The patients are able to take advantage of this ROM increase in ADLs in flexion and in most ADL in abduction, but only in trend in internal and external rotation.
Level IV, Case Series with no comparison group.

• 出版日期2014-8