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Consequences of scapular anatomy for reversed total shoulder arthroplasty

BART MIDDERNACHT UGent, PIETER-JAN DE ROO UGent, GEORGES VAN MAELE UGent and Lieven De Wilde UGent (2008) CLINICAL ORTHOPAEDICS AND RELATED RESEARCH. 466(6). p.1410-1418
abstract
The reverse total shoulder prosthesis provides successful functional outcome in many patients with rotator cuff tear arthropathy. However, scapular notching, a direct consequence of mechanical impingement between the humeral prosthesis and the glenoid, remains a major concern. We presumed a better knowledge of the anatomy of the scapula would enable design or placement modifications to minimize this phenomenon. After establishing a uniform spatial reference system using easy locatable surgical reference points and planes, we analyzed 200 dry bony scapulae and defined the glenoid and infraglenoid anatomy relative to the reference system. The bony rim of the two inferior quadrants of the glenoid forms a semicircle the center of which can be used perioperatively as an easy locatable bony reference point. The infraglenoid tubercle varies in width and length, and can interfere with the humeral part of the reverse prosthesis, creating scapular notching. To avoid notching, we suggest using a convex base plate with a smaller radius than currently used, placing it as low as possible with a 42-mm glenosphere eccentrically assembled to create a posterior offset. If prosthetic overhang cannot be obtained, we suggest removing part of the infraglenoid tubercle.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
CUFF TEAR, GLENOHUMERAL OSTEOARTHRITIS, PROSTHESIS, ARTHRITIS, DESIGN, FAILURE, RUPTURE, LENGTH
journal title
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH
Clin. Orthop. Rel. Res.
volume
466
issue
6
pages
1410 - 1418
Web of Science type
Article
Web of Science id
000255855600026
JCR category
ORTHOPEDICS
JCR impact factor
1.893 (2008)
JCR rank
16/49 (2008)
JCR quartile
2 (2008)
ISSN
0009-921X
DOI
10.1007/s11999-008-0187-6
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
434069
handle
http://hdl.handle.net/1854/LU-434069
date created
2008-10-30 12:02:00
date last changed
2015-06-17 11:04:07
@article{434069,
  abstract     = {The reverse total shoulder prosthesis provides successful functional outcome in many patients with rotator cuff tear arthropathy. However, scapular notching, a direct consequence of mechanical impingement between the humeral prosthesis and the glenoid, remains a major concern. We presumed a better knowledge of the anatomy of the scapula would enable design or placement modifications to minimize this phenomenon. After establishing a uniform spatial reference system using easy locatable surgical reference points and planes, we analyzed 200 dry bony scapulae and defined the glenoid and infraglenoid anatomy relative to the reference system. The bony rim of the two inferior quadrants of the glenoid forms a semicircle the center of which can be used perioperatively as an easy locatable bony reference point. The infraglenoid tubercle varies in width and length, and can interfere with the humeral part of the reverse prosthesis, creating scapular notching. To avoid notching, we suggest using a convex base plate with a smaller radius than currently used, placing it as low as possible with a 42-mm glenosphere eccentrically assembled to create a posterior offset. If prosthetic overhang cannot be obtained, we suggest removing part of the infraglenoid tubercle.},
  author       = {MIDDERNACHT, BART and DE ROO, PIETER-JAN and VAN MAELE, GEORGES and De Wilde, Lieven},
  issn         = {0009-921X},
  journal      = {CLINICAL ORTHOPAEDICS AND RELATED RESEARCH},
  keyword      = {CUFF TEAR,GLENOHUMERAL OSTEOARTHRITIS,PROSTHESIS,ARTHRITIS,DESIGN,FAILURE,RUPTURE,LENGTH},
  language     = {eng},
  number       = {6},
  pages        = {1410--1418},
  title        = {Consequences of scapular anatomy for reversed total shoulder arthroplasty},
  url          = {http://dx.doi.org/10.1007/s11999-008-0187-6},
  volume       = {466},
  year         = {2008},
}

Chicago
MIDDERNACHT, BART, PIETER-JAN DE ROO, Georges Van Maele, and Lieven De Wilde. 2008. “Consequences of Scapular Anatomy for Reversed Total Shoulder Arthroplasty.” Clinical Orthopaedics and Related Research 466 (6): 1410–1418.
APA
MIDDERNACHT, B., DE ROO, P.-J., Van Maele, G., & De Wilde, L. (2008). Consequences of scapular anatomy for reversed total shoulder arthroplasty. CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 466(6), 1410–1418.
Vancouver
1.
MIDDERNACHT B, DE ROO P-J, Van Maele G, De Wilde L. Consequences of scapular anatomy for reversed total shoulder arthroplasty. CLINICAL ORTHOPAEDICS AND RELATED RESEARCH. 2008;466(6):1410–8.
MLA
MIDDERNACHT, BART, PIETER-JAN DE ROO, Georges Van Maele, et al. “Consequences of Scapular Anatomy for Reversed Total Shoulder Arthroplasty.” CLINICAL ORTHOPAEDICS AND RELATED RESEARCH 466.6 (2008): 1410–1418. Print.