Effect of the critical shoulder angle on severe cranialization following total shoulder arthroplasty

Matthias Wolf; Matthias Bülhoff; Patric Raiss; Felix Zeifang; Michael W Maier

doi:10.1016/j.jor.2020.03.024

Effect of the critical shoulder angle on severe cranialization following total shoulder arthroplasty

J Orthop. 2020 Mar 25:21:240-244. doi: 10.1016/j.jor.2020.03.024. eCollection 2020 Sep-Oct.

Authors

Matthias Wolf¹, Matthias Bülhoff¹, Patric Raiss², Felix Zeifang³, Michael W Maier¹

Affiliations

¹ Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany.
² OCM Klinik, Steinerstrasse 6, 81369, München, Germany.
³ ETHIANUM Klinik, Voßstraße 6, 69115, Heidelberg, Germany.

Abstract

Purpose: This study assesses the relationship of CSA, cranialization and radiographic glenoid loosening following TSA in the long-term follow-up.

Methods: 26 shoulders with TSA were examined radiographically postoperatively and after a mean 12.6 years. Severe cranialization was defined as direct humeral contact with the acromion and/or acetabularization of the acromion.

Results: A CSA ≥35° was associated with severe cranialization. Glenoid loosening was present in 6/24 shoulders (25%). Severe cranialization was associated with glenoid loosening (p = 0.003).

Conclusion: A postoperative CSA ≥ 35° was associated with severe humeral cranialization after TSA in the long-term follow-up. Severe cranialization correlated with glenoid loosening.Level of evidence IV - retrospective cohort study.

Keywords: CSA, Critical Shoulder Angle; Cranialization; Critical shoulder angle; Glenoid loosening; Rotator cuff insufficiency; TSA, Total Shoulder Arthroplasty; Total shoulder arthroplasty.