Postoperative acromiohumeral interval affects shoulder range of motions following reverse total shoulder arthroplasty

Abstract

Reverse total shoulder arthroplasty (RTSA) improves function and reduces pain for patients with complex shoulder problems. However, there is a lack of literature regarding the association of radiographic parameters on clinical outcomes after RTSA. The aim of this study was to analyze various radiographic parameters that may be predictive of clinical outcomes after RTSA. A total of 55 patients treated with RTSA were enrolled. Shoulder radiographic parameters were used for measurement of critical shoulder angle, acromial index, acromiohumeral interval, deltoid lever arm, acromial angulation, glenoid version, and acromial height. Preoperative and postoperative clinical outcomes were evaluated at a minimum 2-year follow-up. An analysis of correlations between radiographic parameters and clinical outcomes was then performed. A significant change in critical shoulder angle, acromiohumeral interval, and deltoid lever arm was observed between preoperative and postoperative radiographic measurements. A significant improvement was observed in all clinical outcomes and range of motions from preoperative to postoperative (all p < 0.001). A negative correlation of postoperative acromiohumeral interval with forward flexion (r = - 0.270; p = 0.046), external rotation (r = - 0.421; p = 0.001), and internal rotation (r = 0.275; p = 0.042) was observed at final follow-up. In addition, postoperative acromiohumeral interval less than 29 mm had an 86% positive predictive value of obtaining 130° of forward flexion and 45° of external rotation. It was found that postoperative acromiohumeral interval showed an association with active range of motion in patients who underwent RTSA. In particular, excessive distalization reduced forward flexion and external rotation motion of the shoulder in patients treated with RTSA.