How sensitive is the deltoid moment arm to humeral offset changes with reverse total shoulder arthroplasty?

Journal of Shoulder and Elbow Surgery
David R WalkerScott A Banks

Abstract

Reverse total shoulder arthroplasty commonly treats cuff-deficient or osteoarthritic shoulders not amenable to rotator cuff repair. This study investigates deltoid moment arm sensitivity to variations in the joint center and humeral offset of 3 representative reverse total shoulder arthroplasty subjects. We hypothesized that a superior joint implant placement may exist, indicated by muscle moment arms, compared with the current actual surgical implant configuration. Moment arms for the anterior, lateral, and posterior aspects of the deltoid muscle were determined for 1521 perturbations of the humeral offset location away from the surgical placement in a subject-specific musculoskeletal model with motion defined by subject-specific in vivo abduction kinematics. The humeral offset was varied from its surgical position ±4 mm in the anterior/posterior direction, ±12 mm in the medial/lateral direction, and -10 to 14 mm in the superior/inferior direction. The anterior deltoid moment arm varied in humeral offset and center of rotation up to 20 mm, primarily in the medial/lateral and superior/inferior directions. The lateral deltoid moment arm varied in humeral offset up to 20 mm, primarily in the medial/lateral and anterior/posterior ...Continue Reading

References

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Citations

Oct 23, 2020·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Albert FerrandoOfer Levy
Dec 3, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Melissa A Wright, Anand M Murthi
Jul 6, 2020·Journal of Shoulder and Elbow Surgery·Alicia M KerriganGeorge S Athwal

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