Do glenoid retroversion and humeral subluxation affect outcomes following total shoulder arthroplasty?

C. Benjamin Ma, MD; Weiyuan Xiao, MD; Madeleine Salesky, AB; Edward Cheung, MD; Alan L. Zhang, MD; Brian T. Feeley, MD; Drew A. Lansdown, MD

JSES International (Sep 2020)

Do glenoid retroversion and humeral subluxation affect outcomes following total shoulder arthroplasty?

C. Benjamin Ma, MD,
Weiyuan Xiao, MD,
Madeleine Salesky, AB,
Edward Cheung, MD,
Alan L. Zhang, MD,
Brian T. Feeley, MD,
Drew A. Lansdown, MD

Affiliations

C. Benjamin Ma, MD: Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, CA, USA
Weiyuan Xiao, MD: Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, CA, USA
Madeleine Salesky, AB: Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, CA, USA
Edward Cheung, MD: Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, CA, USA
Alan L. Zhang, MD: Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, CA, USA
Brian T. Feeley, MD: Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, CA, USA
Drew A. Lansdown, MD: Corresponding author: Drew A. Lansdown, MD, University of California, 1500 Owens Street, Suite 170, San Francisco, CA 94158, USA.; Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, CA, USA

Journal volume & issue: Vol. 4, no. 3
pp. 649 – 656

Abstract

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Background: Glenoid retroversion and humeral head subluxation have been suggested to lead to inferior outcomes after total shoulder arthroplasty (TSA). There are limited data to support this suggestion. We investigated whether preoperative glenoid retroversion and humeral head subluxation are associated with inferior outcomes after TSA and whether change of retroversion influences outcomes after TSA. Methods: Patients undergoing TSA with minimum 2-year follow-up were included from a prospectively collected institutional shoulder arthroplasty database. Retroversion and humeral head subluxation before and after surgery were measured on axillary radiographs. Postoperative radiographs were -evaluated for glenoid component loosening and compared between groups. Spearman correlations were determined between retroversion measurements and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) scores. Patients were analyzed in groups based on retroversion and humeral head subluxation. Results: There were 113 patients (50% follow-up rate) evaluated at 4.2 years postoperatively. The mean preoperative retroversion (15.3° ± 7.7°) was significantly higher than postoperative retroversion (10.0° ± 6.8°; P 15°, there was no difference in outcome scores based on postoperative retroversion. There were no differences in preoperative or postoperative version for patients with or without glenoid lucencies. Discussion: We observed no significant relationship between postoperative glenoid retroversion or humeral head subluxation and clinical outcomes in patients following TSA. For patients with preoperative retroversion >15°, change of retroversion during TSA had no impact on their clinical outcomes at short-term follow-up.

Published in JSES International

ISSN: 2666-6383 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery; Medicine: Internal medicine: Specialties of internal medicine: Diseases of the musculoskeletal system
Website: https://www.journals.elsevier.com/jses-international

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