In vivo three-dimensional scapular kinematic alterations after reverse total shoulder arthroplasty

Abstract

Background: In vivo three-dimensional (3D) kinematics of the scapula after reverse total shoulder arthroplasty (rTSA) have been sparsely investigated. The aim of this study was to analyze static and dynamic kinematic alterations of the scapula after rTSA in vivo with the use of computer-aided 3D reconstruction program. Methods: A total of 15 patients with cuff tear arthropathy treated by rTSA participated. Scapulae with rTSA and the contralateral scapulae were evaluated with computed tomography scan data in 0° and 120° forward flexion positions of the glenohumeral joint. To examine static scapular kinematic alterations, the angular position and distance from the thorax were evaluated in the shoulder neutral position. 3D rotational and translational movements of the scapula in relation to the thorax were also measured during arm elevation to evaluate dynamic scapular kinematic alterations. Results: Scapulae with rTSA were more anteriorly tilted in the sagittal plane and more internally rotated in the axial plane than were the contralateral scapulae. However, no significant differences were observed in the upward rotated position in the coronal plane or in the distance from the thorax in any plane between the scapulae with rTSA and the contralateral scapulae. In dynamic analyses, upward rotational movement in the coronal plane, external rotation in the axial plane, and posterior tilting in the sagittal plane showed significant differences between the scapulae with rTSA and the contralateral scapulae during elevation. In contrast, translational movements in coordination revealed no statistical differences between the two scapular groups except for lateral translation. Conclusion: Data from the 3D reconstruction program showed that rTSA might result in static positional changes and dynamic movement alterations. Level of Evidence: Therapeutic, IV