The anteromedial approach for shoulder arthroplasty: the importance of the anterior deltoid

Journal of Shoulder and Elbow Surgery
David R J GillCharles Rowland

Abstract

Protection of the anterior aspect of the deltoid muscle is critical to the success of shoulder arthroplasty. Between 1975 and 1980, 75 patients with 81 shoulder arthroplasties had exposure via the anteromedial approach with careful anterior deltoid detachment through fascial tissues, systematic repair, and standardized rehabilitation with early passive range of motion. As with other reports on arthroplasty, pain was significantly reduced and motion was improved. No anterior deltoid detachments occurred; deltoid strength was preserved. Greater postoperative deltoid strength was statistically associated with lesser postoperative pain, greater postoperative active elevation, improved limb function, and an enhanced overall result rating. To understand the contemporary indications for this approach better, those undergoing shoulder arthroplasty between 1990 and 1994 were assessed. The anteromedial approach was used in 14 of these 236 shoulders (5.9%). This approach is currently reserved for patients with frail anterior deltoids that will not tolerate retraction, with severely osteopenic humeral shafts that will not tolerate torsion, with extreme scarring and an inflexible deltoid muscle, with severe bony deformity, or with posterosu...Continue Reading

Citations

Oct 3, 2008·The Journal of Bone and Joint Surgery. American Volume·Michael J TauntonRobert H Cofield
Jul 3, 2010·The Journal of Bone and Joint Surgery. British Volume·A M ForuriaR H Cofield
May 18, 2011·The Open Orthopaedics Journal·Joaquin Sanchez-Sotelo
Nov 21, 2017·The Open Orthopaedics Journal·Bogdan A Matache, P Lapner
Mar 4, 2009·The Journal of Bone and Joint Surgery. American Volume·George S AthwalRobert H Cofield
Dec 19, 2008·The Journal of Bone and Joint Surgery. British Volume·A CilR H Cofield
Dec 20, 2008·Journal of Anatomy·J N A L LeijnseY H Kwon
Feb 27, 2016·The Journal of the American Academy of Orthopaedic Surgeons·Peter Nissen ChalmersScott W Trenhaile
Feb 3, 2009·Journal of Shoulder and Elbow Surgery·Damian M RispoliRobert H Cofield

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