A kinematic and electromyographic comparison of a Grammont-style reverse arthroplasty combined with a l’Episcopo transfer compared to a lateralized humeral component reverse for restoration of active external rotation

Purpose To assess kinematic and electromyographic findings of two designs of reverse total shoulder arthroplasty (RTSA). We tested two hypotheses: (H 1 ) Grammont-style (RTSA) with l’Episcopo tendon transfer gains similar postoperative kinematic findings of a lateralized humeral component RTSA witho...

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Published in:International orthopaedics 2021-08, Vol.45 (8), p.2061-2069
Main Authors: Merolla, Giovanni, Cuoghi, Francesco, Athwal, George S., Parel, Ilaria, Filippi, Maria V., Cutti, Andrea G., Fabbri, Elisabetta, Padolino, Antonio, Paladini, Paolo, Catani, Fabio, Porcellini, Giuseppe
Format: Article
Language:English
Subjects:
Medicine
Medicine & Public Health
Original Paper
Orthopedics
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Summary:Purpose To assess kinematic and electromyographic findings of two designs of reverse total shoulder arthroplasty (RTSA). We tested two hypotheses: (H 1 ) Grammont-style (RTSA) with l’Episcopo tendon transfer gains similar postoperative kinematic findings of a lateralized humeral component RTSA without a tendon transfer; (H 2 ) RTSA with lateralized humeral component induces earlier shoulder muscle activation during shoulder motion compared with standard Grammont prosthesis with l’Episcopo transfer. Methods Twenty-five patients with a cuff tear arthropathy, pseudoparalysis, and a positive dropping sign were sequentially included. A Grammont-style RTSA with a l’Episcopo tendon transfer was implanted in 13 patients (medialized humerus and transfer group) and an on-lay curved-stem RTSA in 12 (lateralized humerus group). Constant score; the disabilities of the arm, shoulder, and hand (DASH) score; and active shoulder range of motion (flexion, abduction, external rotation, and internal rotation) were measured pre- and postoperatively. Upper limb kinematic and surface electromyography (EMG) (anterior and posterior deltoid; upper, middle, and lower trapezius; and the upper and lower latissimus dorsi muscles) were recorded during active range of motion. Results At > 24 months of follow-up, the Constant and DASH scores and active shoulder range of motion improved in both groups (p 
ISSN:0341-2695
1432-5195
DOI:10.1007/s00264-021-05122-1