Edoardo Franceschetti, Pietro Gregori, Alice Laudisio, Chiara De Andreis, Giovanni Perricone, Giancarlo Giurazza, Michele Paciotti, Umile Giuseppe Longo, Rocco Papalia
{"title":"在至少2年的随访中，应力屏蔽会影响短柄逆行肩关节置换术后的肩关节功能，并且可以使用术前计划软件进行预测：一项回顾性队列研究。","authors":"Edoardo Franceschetti, Pietro Gregori, Alice Laudisio, Chiara De Andreis, Giovanni Perricone, Giancarlo Giurazza, Michele Paciotti, Umile Giuseppe Longo, Rocco Papalia","doi":"10.1177/17585732251314386","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to assess if 3D CT-scan-based planification of distal filling ratio (DFR) is accurate when compared to postoperative DFR calculated on plain X-rays. A secondary aim was to investigate if an association between clinical outcomes and the degree of stress shielding (SS) exists.</p><p><strong>Methods: </strong>Fifty patients with short-stem reverse shoulder arthroplasties, preoperative CT scans, and a minimum 24-month radiographic follow-up were included in the study. At 24 months follow-up, all patients were evaluated by assessing the postoperative filling ratios, the 3D DFRs, the simple shoulder test, Constant-Murley score, and visual analogue scale through a prospectively data collection and statistically analyzed.</p><p><strong>Results: </strong>A correlation between the 3D DFR and SS onset (r<sub>s</sub> 0.54; <i>P</i> < 0.001), and between postoperative DFR and SS (r<sub>s</sub> 0.71; <i>P</i> < 0.001), was found. The 3D DFR and the postoperative DFR were correlated (r<sub>s</sub> 0.89; <i>P</i> < 0.0001). SS negatively affects the postoperative range of motion, decreasing the forward elevation of the shoulder.</p><p><strong>Conclusion: </strong>The calculation of DFR based on 3D CT planning is a good predictor of humeral SS after short-stem RTAs. The presence of SS decreases clinical outcomes by lowering the anterior elevation of the shoulder.</p><p><strong>Level of evidence: </strong>Case series.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251314386"},"PeriodicalIF":1.5000,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803596/pdf/","citationCount":"0","resultStr":"{\"title\":\"Stress shielding influences shoulder function after reverse shoulder arthroplasty using a short stem at minimum 2 years follow-up and can be predicted using a preoperative planning software: A retrospective cohort study.\",\"authors\":\"Edoardo Franceschetti, Pietro Gregori, Alice Laudisio, Chiara De Andreis, Giovanni Perricone, Giancarlo Giurazza, Michele Paciotti, Umile Giuseppe Longo, Rocco Papalia\",\"doi\":\"10.1177/17585732251314386\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The aim of the study was to assess if 3D CT-scan-based planification of distal filling ratio (DFR) is accurate when compared to postoperative DFR calculated on plain X-rays. A secondary aim was to investigate if an association between clinical outcomes and the degree of stress shielding (SS) exists.</p><p><strong>Methods: </strong>Fifty patients with short-stem reverse shoulder arthroplasties, preoperative CT scans, and a minimum 24-month radiographic follow-up were included in the study. At 24 months follow-up, all patients were evaluated by assessing the postoperative filling ratios, the 3D DFRs, the simple shoulder test, Constant-Murley score, and visual analogue scale through a prospectively data collection and statistically analyzed.</p><p><strong>Results: </strong>A correlation between the 3D DFR and SS onset (r<sub>s</sub> 0.54; <i>P</i> < 0.001), and between postoperative DFR and SS (r<sub>s</sub> 0.71; <i>P</i> < 0.001), was found. The 3D DFR and the postoperative DFR were correlated (r<sub>s</sub> 0.89; <i>P</i> < 0.0001). SS negatively affects the postoperative range of motion, decreasing the forward elevation of the shoulder.</p><p><strong>Conclusion: </strong>The calculation of DFR based on 3D CT planning is a good predictor of humeral SS after short-stem RTAs. The presence of SS decreases clinical outcomes by lowering the anterior elevation of the shoulder.</p><p><strong>Level of evidence: </strong>Case series.</p>\",\"PeriodicalId\":36705,\"journal\":{\"name\":\"Shoulder and Elbow\",\"volume\":\" \",\"pages\":\"17585732251314386\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-02-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803596/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Shoulder and Elbow\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/17585732251314386\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Shoulder and Elbow","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/17585732251314386","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Stress shielding influences shoulder function after reverse shoulder arthroplasty using a short stem at minimum 2 years follow-up and can be predicted using a preoperative planning software: A retrospective cohort study.
Background: The aim of the study was to assess if 3D CT-scan-based planification of distal filling ratio (DFR) is accurate when compared to postoperative DFR calculated on plain X-rays. A secondary aim was to investigate if an association between clinical outcomes and the degree of stress shielding (SS) exists.
Methods: Fifty patients with short-stem reverse shoulder arthroplasties, preoperative CT scans, and a minimum 24-month radiographic follow-up were included in the study. At 24 months follow-up, all patients were evaluated by assessing the postoperative filling ratios, the 3D DFRs, the simple shoulder test, Constant-Murley score, and visual analogue scale through a prospectively data collection and statistically analyzed.
Results: A correlation between the 3D DFR and SS onset (rs 0.54; P < 0.001), and between postoperative DFR and SS (rs 0.71; P < 0.001), was found. The 3D DFR and the postoperative DFR were correlated (rs 0.89; P < 0.0001). SS negatively affects the postoperative range of motion, decreasing the forward elevation of the shoulder.
Conclusion: The calculation of DFR based on 3D CT planning is a good predictor of humeral SS after short-stem RTAs. The presence of SS decreases clinical outcomes by lowering the anterior elevation of the shoulder.
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