Search

Background: Shoulder proprioception in patients with glenohumeral osteoarthritis and the effect of total shoulder arthroplasty (TSA) on proprioception have been evaluated previously. Measuring proprioception with an active angle reproduction (AAR) test, proprioception remained unchanged or deteriorated in a short follow-up period after shoulder replacement. Therefore, the purpose of this prospective study was to evaluate the influence of the preoperative Constant score (CS) on postoperative proprioceptive outcome after TSA in patients with primary osteoarthritis to address the question of whether the preoperative state of shoulder function influences postoperative proprioceptive outcome. Methods: Twenty-four patients who received total shoulder arthroplasty (TSA) ( n = 24) for primary osteoarthritis of the shoulder were enrolled. After retrospectively analyzing the preoperative CS for 120 patients with primary osteoarthritis of the shoulder who received TSA, the patient group was divided into three subgroups according to preoperative functional assessment of the shoulder using the CS. Group one consisted of patients with CS < 20, group two patients with CS 20-30, and group three patients with the best preoperative CS (>30). In all patients proprioception was examined 1 day before the operation and 3 months after surgery by 3D motion analysis with an AAR test and also CS. Results: Postoperatively, proprioception in group one (CS < 20) deteriorated significantly from 5.2° (SD 2.2) to 8.1° (SD 1.8); p = 0.018. In group two, there were no significant changes from preoperative to postoperative status [8.7° (SD 2.1) vs. 9.3° (SD 2.7) ( p = 0.554)], likewise in group three [6.3° (SD 2.3) preoperatively vs. 6.9° (SD 3.3) postoperatively ( p = 0.617)]. Comparing the postoperative results, the best proprioception [6.9° (SD 3.3)] was found in the group that had the best preoperative CS (group three, CS > 30). Conclusion: In conclusion, a low preoperative CS is a negative predictive factor for postoperative proprioception after TSA. We should keep that in mind when determining the best timepoint for shoulder replacement in patients with glenohumeral osteoarthritis. [ABSTRACT FROM AUTHOR]

Background: 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). Methods: 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. Results: 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 43° (SD ± 31) from 66° to 109° ( p = 0.001), for active abduction of about 37° (SD ± 26) from 57° to 94° ( p = 0.001), and for the active adduction of about 28° (SD ± 10) from 5° to 33° ( 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. Conclusion: 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 of evidence: Level IV, Case Series with no comparison group. [ABSTRACT FROM AUTHOR]

Background: This prospective study evaluated the development of proprioception over the course of 3 years after shoulder arthroplasty. Methods: Twenty-one patients were enrolled who underwent total shoulder arthroplasty ( n = 10) or hemiarthroplasty (HEMI) ( n = 11) for shoulder osteoarthritis. All patients were examined 1 day before the operation, 6 months and 3 years after surgery in a motion analysis study with an active angle-reproduction (AAR) test. Results: Overall proprioception measured by the AAR deteriorated significantly 3 years after surgery [from 6.6° (SD 3.1) to 10.3° (SD 5.7); p = 0.017] and was significantly worse than in the control group [10.3° (SD 5.7) vs. 7.8° (SD 2.3); p = 0.030). In the HEMI subgroup, 3 years after shoulder replacement, there is a significant deterioration of proprioception at 30° of external rotation [from 3.1° (SD 3.5) to 12.8° (SD 10.7); p = 0.031]. On average, in the TSA subgroup proprioception deteriorated from 7.1° (SD 3.1) to 8.6° (SD 1.4) and in the HEMI subgroup from 6.1° (SD 2.1) to 12.4° (SD 8.3). The comparison of postoperative impairment of proprioception between the TSA and HEMI subgroup showed significantly worse proprioception for the HEMI subgroup at 30° of external rotation [9.8° (SD 10.1) vs. 1.6° (SD 6.3) in the TSA group; p = 0.046]. Conclusion: In conclusion, proprioception that was measured by an AAR test remained unchanged or deteriorated 3 years after shoulder arthroplasty. The postoperative deterioration of proprioception was more distinctive in HEMI than in TSA group. [ABSTRACT FROM AUTHOR]