This retrospective cohort tested whether scapulothoracic posture affects real-world outcomes after reverse total shoulder arthroplasty. Patients were sorted into posture types A, B, and C using scapular internal rotation on preoperative cross-sectional imaging. It asks whether prior CT and computer-simulation predictions actually translate to clinical practice.
When you evaluate a patient for reverse shoulder arthroplasty, look at the scapula on the preoperative CT or MRI, not just the glenoid. Type C posture (scapular internal rotation over 46 degrees, usually with thoracic kyphosis and a barrel chest) predicts worse flexion, abduction, function, and pain at 2 years.
The practical lever this paper identifies is the distalization shoulder angle. A higher DSA improved abduction specifically in type C patients, so implant configuration that increases distalization is a reasonable planning goal in these shoulders.
Rotation was preserved across posture types, so counsel patients that poor posture mainly threatens overhead elevation, not reach-behind-the-back function.
Weigh evidence carefully: this is a Level III retrospective cohort with moderate absolute ROM differences and a complication trend that did not reach significance. It confirms prior simulation work in 681 real patients but cannot prove that adjusting implants changes outcomes.
This retrospective cohort tested whether scapulothoracic posture affects real-world outcomes after reverse total shoulder arthroplasty. Patients were sorted into posture types A, B, and C using scapular internal rotation on preoperative cross-sectional imaging. It asks whether prior CT and computer-simulation predictions actually translate to clinical practice.
When you evaluate a patient for reverse shoulder arthroplasty, look at the scapula on the preoperative CT or MRI, not just the glenoid. Type C posture (scapular internal rotation over 46 degrees, usually with thoracic kyphosis and a barrel chest) predicts worse flexion, abduction, function, and pain at 2 years.
The practical lever this paper identifies is the distalization shoulder angle. A higher DSA improved abduction specifically in type C patients, so implant configuration that increases distalization is a reasonable planning goal in these shoulders.
Rotation was preserved across posture types, so counsel patients that poor posture mainly threatens overhead elevation, not reach-behind-the-back function.
Weigh evidence carefully: this is a Level III retrospective cohort with moderate absolute ROM differences and a complication trend that did not reach significance. It confirms prior simulation work in 681 real patients but cannot prove that adjusting implants changes outcomes.