Original articleEvaluation of abduction range of motion and avoidance of inferior scapular impingement in a reverse shoulder model
Section snippets
Materials and methods
Reverse shoulder implant components consisted of a ball that was attached to the glenoid (glenosphere) and a humeral socket that was attached to a wooden dowel. These components were manufactured using Delrin (DuPont, Wilmington, DE), which is a wear-resistant, low-friction plastic. The glenospheres were manufactured with 3 diameters (30, 36, and 42 mm) and 3 COR offsets (0 mm or hemispherical, +5 mm, and +10 mm offset from the glenoid), as summarized in Table I. The glenoid components were
Total abduction range of motion
The greatest total abduction ROM was 117.5° (42 mm, +10-mm COR, and inferior, 170°), whereas the least maximum total abduction ROM was 40.2° (30 mm, 0-mm COR, and neutral, 170°; and 30 mm, 0-mm COR, and neutral, 150°; Table II). Maximal abduction was limited by impingement on either the acromion or the superior edge of the glenoid. Significant effects on total glenohumeral abduction ROM were found for all the factors studied (P < .0001). The factor with the greatest effect on total abduction
Discussion
A careful analysis of the outcomes after reverse shoulder replacement reveals variable improvement in shoulder elevation.2, 3, 12 To judge these improvements accurately, isolated glenohumeral motion must be evaluated; however, this information has been largely lacking up to now. Seebauer et al9, 10 conducted the only clinical study to isolate the improvement in glenohumeral elevation after a reverse shoulder implant. On the basis of dynamic fluoroscopic radiographs, they reported that the
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This research was supported in part by the Florida Orthopaedic Institute Research Foundation.