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Scapular notching, erosion of the scapular neck related to impingement by the medial rim of the humeral cup during adduction, is a radiographic sign specific to reverse shoulder arthroplasty (RSA). Its clinical and radiological consequences remain unclear. QUESTIONS/
Therefore, we: (1) determined the incidence of notching in a large series, (2) described the natural history of notching, (3) determined whether notching is related to functional scores or (4) radiographic signs of failure, and (5) identified factors related to notch development. PATIENTS AND
We retrospectively reviewed 448 patients who underwent a Grammont-type RSA (461 shoulders) with a mean followup of 51 months (range, 24-206 months). RSA was implanted for cuff tear arthropathy or osteoarthritis with cuff deficiency. We assessed scapular notching using AP views standardized under fluoroscopy. Clinical assessment included Constant-Murley score and range of motion. Aside from notching, radiographic assessment included evaluation of humeral and glenoid radiolucent lines.
Notching occurred in 68% of cases. It appeared early, but its later evolution was variable. Notching was associated with followup, strength, passive and active elevation, humeral radiolucent lines, and glenoid lucent lines. It also correlated with a higher rate in patients with preoperative superior erosion.
Scapular notching is frequent, generally progresses, and is associated with deterioration of some clinical parameters and radiolucent lines. We believe the preoperative pattern of glenoid erosion is of particular importance due to its influence on the surgeon's glenoid preparation and base-plate positioning. It is crucial to avoid cranial position and superior tilt. LEVELS OF
Level IV, Therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Clinique du parc, 155 ter Bd Stalingrad, 69006, Lyon, France, firstname.lastname@example.org.
This article was published in the following journal.
Name: Clinical orthopaedics and related research
Scapular motion is essential for full, functional mobility of the arm. Many shoulder pathologies are associated with alterations of scapular kinematics which have been only little studied in total sho...
Complex proximal humeral fractures may require prosthetic replacement of the humeral head. Surgical options include reverse shoulder arthroplasty (RSA) and shoulder hemiarthroplasty; however, the opti...
To compare the outcomes of reverse shoulder arthroplasty (RSA) between patients with failed proximal humeral locking plate (PHLP) fixation and those with acute fractures.
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The purpose of this study is to determine if stabilizing the scapula (shoulder blade) during a common shoulder stretch is more effective at improving shoulder range of motion than not stab...
The purpose of this study is to prospectively evaluate two FDA approved implant designs for the Tornier Reverse Shoulder arthroplasty. The small difference in design is the amount of offse...
The aims of this study are to investigate the effects of scapular muscle fatigue on scapular joint position sense and neuromuscular performance (scapular muscle strength, the kinematics da...
Background: Patterns of scapular dyskinesis have unique scapular kinematics and associated muscular activation. The characteristics of scapular dyskinesis may be associated with functional...
The purpose of this study is to determine the limited effectiveness of drains during Total Shoulder Arthroplasty. Drains are used during joint arthroplasty procedures to decrease infection...
Unilateral or bilateral pain of the shoulder. It is often caused by physical activities such as work or sports participation, but may also be pathologic in origin.
The application of drug preparations to the surfaces of the body, especially the skin (ADMINISTRATION, CUTANEOUS) or mucous membranes. This method of treatment is used to avoid systemic side effects when high doses are required at a localized area or as an alternative systemic administration route, to avoid hepatic processing for example.
A variation of the PCR technique in which cDNA is made from RNA via reverse transcription. The resultant cDNA is then amplified using standard PCR protocols.
DNA sequences that form the coding region for retroviral enzymes including reverse transcriptase, protease, and endonuclease/integrase. "pol" is short for polymerase, the enzyme class of reverse transcriptase.
A ribonuclease activity that is a component of the HIV REVERSE TRANSCRIPTASE. It removes the RNA strand of the RNA-DNA heteroduplex produced by reverse transcription. Once the RNA moiety is removed a double stranded DNA copy of the HIV RNA can be synthesized.
Arthroplasty is a surgical procedure to restore the integrity and function of a joint. A joint can be restored by resurfacing the bones. An artificial joint (called a prosthesis) may also be used. Various types of arthritis may affect the joints. Osteo...
Arthroplasty Joint Disorders Orthopedics Spinal Cord Disorders Orthopedics is the science or practice of correcting deformities caused by disease or damage to the bones and joints of the skeleton. This specialized branch of surgery may ...
Arthritis is by definition the inflammation of one or more joints, characterized by swelling, pain, warmth, redness and diminished range of joint movement (Oxford Medical Dictionary). There are many different types; Noninflammatory; Osteoarthritis, N...