Alexander J Vervaecke, Beatrice Ricciardi, François Boux de Casson, Aurore Blancheton, Victor Housset, Alexandre Caubère, Marc-Olivier Gauci, Jean-David Werthel
{"title":"肱骨假体对逆行全肩关节置换术后手臂冠状面位置的影响。","authors":"Alexander J Vervaecke, Beatrice Ricciardi, François Boux de Casson, Aurore Blancheton, Victor Housset, Alexandre Caubère, Marc-Olivier Gauci, Jean-David Werthel","doi":"10.1007/s00264-025-06650-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Variability in the resting arm position may influence impingement-free range of motion (ROM) after reverse total shoulder arthroplasty (rTSA). The relationship between the neck-shaft angle (NSA) and arm position remains unclear. This study evaluated the humerothoracic angle (HTA) as a proxy for the resting arm position in the coronal plane, its variability and change after rTSA, and its associations with NSA.</p><p><strong>Methods: </strong>This multicenter prospective study included 172 patients who underwent rTSA by nine surgeons. Standard radiographs were obtained preoperatively and at two years. Radiographic measurements of HTA and true NSA were blinded. Intraclass correlation coefficients (ICC) were calculated for HTA. Paired t-tests and ANOVA assessed group differences. Regression analyses evaluated predictors of postoperative HTA and HTA changes.</p><p><strong>Results: </strong>Preoperative HTA (9.5° ± 8.6°) increased significantly to 13.2° ± 10.2° postoperatively (p < .001). NSA > 145° resulted in higher postoperative HTA than NSA < 135° (p < .0001). Multiple regression showed that NSA (β = 0.4; p < .0001) and preoperative HTA (β = 0.3; p = .0003) were strong predictors of postoperative HTA. Measurement reliability of HTA was excellent (intra-observer ICC = 0.92; inter-observer ICC = 0.89).</p><p><strong>Conclusion: </strong>The resting arm position in the coronal plane, as quantified by HTA, exhibits significant variability pre- and post-rTSA, with a postoperative shift towards greater abduction. NSA strongly influenced the arm position, with larger NSAs being associated with more abducted arm positions. Consideration of how implant alignment and design affect the resting arm position may help refine preoperative planning and optimize impingement-free ROM after rTSA.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The influence of humeral implant alignment on the arm position in the coronal plane after reverse total shoulder arthroplasty.\",\"authors\":\"Alexander J Vervaecke, Beatrice Ricciardi, François Boux de Casson, Aurore Blancheton, Victor Housset, Alexandre Caubère, Marc-Olivier Gauci, Jean-David Werthel\",\"doi\":\"10.1007/s00264-025-06650-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Variability in the resting arm position may influence impingement-free range of motion (ROM) after reverse total shoulder arthroplasty (rTSA). The relationship between the neck-shaft angle (NSA) and arm position remains unclear. This study evaluated the humerothoracic angle (HTA) as a proxy for the resting arm position in the coronal plane, its variability and change after rTSA, and its associations with NSA.</p><p><strong>Methods: </strong>This multicenter prospective study included 172 patients who underwent rTSA by nine surgeons. Standard radiographs were obtained preoperatively and at two years. Radiographic measurements of HTA and true NSA were blinded. Intraclass correlation coefficients (ICC) were calculated for HTA. Paired t-tests and ANOVA assessed group differences. Regression analyses evaluated predictors of postoperative HTA and HTA changes.</p><p><strong>Results: </strong>Preoperative HTA (9.5° ± 8.6°) increased significantly to 13.2° ± 10.2° postoperatively (p < .001). NSA > 145° resulted in higher postoperative HTA than NSA < 135° (p < .0001). Multiple regression showed that NSA (β = 0.4; p < .0001) and preoperative HTA (β = 0.3; p = .0003) were strong predictors of postoperative HTA. Measurement reliability of HTA was excellent (intra-observer ICC = 0.92; inter-observer ICC = 0.89).</p><p><strong>Conclusion: </strong>The resting arm position in the coronal plane, as quantified by HTA, exhibits significant variability pre- and post-rTSA, with a postoperative shift towards greater abduction. NSA strongly influenced the arm position, with larger NSAs being associated with more abducted arm positions. Consideration of how implant alignment and design affect the resting arm position may help refine preoperative planning and optimize impingement-free ROM after rTSA.</p>\",\"PeriodicalId\":14450,\"journal\":{\"name\":\"International Orthopaedics\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-09-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Orthopaedics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00264-025-06650-w\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00264-025-06650-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
The influence of humeral implant alignment on the arm position in the coronal plane after reverse total shoulder arthroplasty.
Purpose: Variability in the resting arm position may influence impingement-free range of motion (ROM) after reverse total shoulder arthroplasty (rTSA). The relationship between the neck-shaft angle (NSA) and arm position remains unclear. This study evaluated the humerothoracic angle (HTA) as a proxy for the resting arm position in the coronal plane, its variability and change after rTSA, and its associations with NSA.
Methods: This multicenter prospective study included 172 patients who underwent rTSA by nine surgeons. Standard radiographs were obtained preoperatively and at two years. Radiographic measurements of HTA and true NSA were blinded. Intraclass correlation coefficients (ICC) were calculated for HTA. Paired t-tests and ANOVA assessed group differences. Regression analyses evaluated predictors of postoperative HTA and HTA changes.
Results: Preoperative HTA (9.5° ± 8.6°) increased significantly to 13.2° ± 10.2° postoperatively (p < .001). NSA > 145° resulted in higher postoperative HTA than NSA < 135° (p < .0001). Multiple regression showed that NSA (β = 0.4; p < .0001) and preoperative HTA (β = 0.3; p = .0003) were strong predictors of postoperative HTA. Measurement reliability of HTA was excellent (intra-observer ICC = 0.92; inter-observer ICC = 0.89).
Conclusion: The resting arm position in the coronal plane, as quantified by HTA, exhibits significant variability pre- and post-rTSA, with a postoperative shift towards greater abduction. NSA strongly influenced the arm position, with larger NSAs being associated with more abducted arm positions. Consideration of how implant alignment and design affect the resting arm position may help refine preoperative planning and optimize impingement-free ROM after rTSA.
期刊介绍：
International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters.
Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable.
The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.
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