Functional workspace and patient-reported outcomes improve after reverse and total shoulder arthroplasty

• Published in: Journal of shoulder and elbow surgery 2019-11, Vol.28 (11), p.2121-2127
• Main Authors: Ngan, Alex, Xiao, Weiyuan, Curran, Patrick F., Tseng, Wo Jan, Hung, Li Wei, Nguyen, Chantal, Matthew, Robert, Ma, Benjamin, Lotz, Jeffrey, Feeley, Brian T.
• Format: Article
• Language: English
• Subjects: Aged; Arthroplasty, Replacement, Shoulder - methods; Cross-Sectional Studies; Female; Follow-Up Studies; functional workspace; Humans; Kinect; Male; Osteoarthritis - physiopathology; Patient Reported Outcome Measures; Postoperative Period; PROMIS; Range of Motion, Articular; reverse total shoulder arthroplasty; Shoulder Joint - physiopathology; Shoulder Joint - surgery; Shoulder osteoarthritis; total shoulder arthroplasty; Treatment Outcome; Upper Extremity - physiopathology; Upper Extremity - surgery
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2019.03.029

Low-cost motion analysis systems (LCMASs) have emerged as easy and practical methods to measure the functional workspace (FWS). Thus, we ventured to apply an LCMAS, the Kinect2 gaming camera, to evaluate the FWS in patients with shoulder osteoarthritis (OA) and patients who underwent total shoulder arthroplasty (TSA) or reverse total shoulder arthroplasty (RTSA). A cross-sectional study of participants with OA (n = 53), TSA (n = 70), and RTSA (n = 34) was performed. The FWS as measured by an LCMAS, the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form score, and the Patient-Reported Outcomes Measurement Information System (PROMIS) score were collected. For participants who underwent TSA or RTSA, the FWS was evaluated at 6, 12, and 24 months postoperatively. The correlation of the FWS with the ASES score and PROMIS score was determined. Significance was set at P < .05. Patients who underwent TSA or RTSA had a significantly higher FWS than patients with shoulder OA at almost all time points. Patients who underwent TSA had a significantly higher FWS than patients who underwent RTSA at 24 months after surgery. PROMIS and ASES scores showed strong correlations with the FWS in patients who underwent TSA (R = 0.75 [P < .001] and R = 0.83 [P < .001], respectively) and RTSA (R = 0.84 [P < .001] and R = 0.73 [P < .001], respectively). The FWS measured by an LCMAS is an easy and low-cost method to quantify the reachable space of the hand in patients and shows strong correlations with patient-reported outcome measures. This may be a useful tool to assess upper-extremity range of motion before and after shoulder arthroplasty.