Thoracic Kyphosis effects on Reverse Total Shoulder Arthropl
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The main goal of this research was to see how thoracic kyphosis affected overhead ROM after rTSA. Patient dissatisfaction has been stated to be as high as 9% after primary reverse complete shoulder arthroplasty (rTSA). The scapula protracts and tilts anteriorly in patients with excessive thoracic kyphosis, which may lead to early impingement with the acromion and loss of forward elevation.

A prospectively collected shoulder registry was retrospectively reviewed for all patients undergoing primary rTSA with a minimum of 2-year follow-up. Preoperative and latest follow-up ROM (forward elevation, abduction, internal rotation, and external rotation), patient-reported outcome measures, and the Constant score were collected.

Postoperative radiographs were evaluated for implant loosening and notching. Patients were separated into three groups according to the thoracic kyphosis angle (less than 25°, 25 to 45°, and more than 45°) and also analyzed as a continuous variable.

Results:
--305 shoulders in 279 patients were reviewed at a mean follow-up of 3.9 years (range 2 to 10 years).

--Female patients and patients with a history of heart disease were statistically more likely to have increased thoracic kyphosis.

--After surgery, forward elevation and abduction were similar among all groups.

--All other postoperative ROM measurements and all patient-reported outcome measures were also similar, regardless of measured kyphosis.

--In addition, no association was observed between the degree of thoracic kyphosis and scapular notching.

Specifically, Despite the fact that excessive thoracic kyphosis is a recognized risk factor for loss of native shoulder overhead motion, shoulders with excessive thoracic kyphosis had similar overhead ROM at early follow-up after primary rTSA.

Source: https://journals.lww.com/jaaos/Abstract/9900/Influence_of_Thoracic_Kyphosis_on_Reverse_Total.162.aspx
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