Shoulder Arthroplasty: Preoperative Evaluation and Postoperative Imaging

Devin Vaswani; Randy M. Cohn; Pamela J. Walsh

doi:10.1055/s-0044-1791727

Seminars in Musculoskeletal Radiology, Table of Contents

Semin Musculoskelet Radiol 2025; 29(01): 045-059
DOI: 10.1055/s-0044-1791727

Review Article

Shoulder Arthroplasty: Preoperative Evaluation and Postoperative Imaging

Authors

Devin Vaswani

¹Department of Radiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Manhasset, New York
Randy M. Cohn

²Department of Orthopedic Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Manhasset, New York
Pamela J. Walsh

¹Department of Radiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Manhasset, New York

Abstract

Shoulder arthroplasty procedures have increased over the past few years. Several different arthroplasty options are available for varying indications, such as humeral head resurfacing, hemiarthroplasty, anatomical total shoulder arthroplasty, and reverse total shoulder arthroplasty, with ongoing modifications of prosthesis components and surgical techniques. Arthroplasty complications are encountered from the acute postoperative period to several years postoperatively. This article reviews the more common types of shoulder arthroplasties: their imaging appearances, multimodality imaging assessments for preoperative planning, and complications.

Keywords

hemiarthroplasty - anatomical total shoulder arthroplasty - reverse total shoulder arthroplasty

Full Text

References

References
1 Farley KX, Wilson JM, Kumar A. et al. Prevalence of shoulder arthroplasty in the United States and the increasing burden of revision shoulder arthroplasty. JBJS Open Access 2021; 6 (03) e20.00156
2 Schairer WW, Nwachukwu BU, Lyman S, Craig EV, Gulotta LV. National utilization of reverse total shoulder arthroplasty in the United States. J Shoulder Elbow Surg 2015; 24 (01) 91-97
3 Wiater JM, Fabing MH. Shoulder arthroplasty: prosthetic options and indications. J Am Acad Orthop Surg 2009; 17 (07) 415-425
4 Rodosky MW, Bigliani LU. Indications for glenoid resurfacing in shoulder arthroplasty. J Shoulder Elbow Surg 1996; 5 (03) 231-248
5 Ricchetti ET, Williams Jr GR. Total shoulder arthroplasty—indications, technique, and results. Oper Tech Orthop 2011; 21 (01) 28-38
6 Wright MA, Keener JD, Chamberlain AM. Comparison of clinical outcomes after anatomic total shoulder arthroplasty and reverse shoulder arthroplasty in patients 70 years and older with glenohumeral osteoarthritis and an intact rotator cuff. J Am Acad Orthop Surg 2020; 28 (05) e222-e229
7 Sheridan BD, Ahearn N, Tasker A, Wakeley C, Sarangi P. Shoulder arthroplasty. Part 1: Prosthesis terminology and classification. Clin Radiol 2012; 67 (07) 709-715
8 Gadea F, Alami G, Pape G, Boileau P, Favard L. Shoulder hemiarthroplasty: outcomes and long-term survival analysis according to etiology. Orthop Traumatol Surg Res 2012; 98 (06) 659-665
9 Cadet ER, Ahmad CS. Hemiarthroplasty for three- and four-part proximal humerus fractures. J Am Acad Orthop Surg 2012; 20 (01) 17-27
10 Mutch J, Laflamme GY, Hagemeister N, Cikes A, Rouleau DM. A new morphological classification for greater tuberosity fractures of the proximal humerus: validation and clinical implications. Bone Joint J 2014; 96-B (05) 646-651
11 Jobin CM, Galdi B, Anakwenze OA, Ahmad CS, Levine WN. Reverse shoulder arthroplasty for the management of proximal humerus fractures. J Am Acad Orthop Surg 2015; 23 (03) 190-201
12 Lin DJ, Wong TT, Kazam JK. Shoulder arthroplasty, from indications to complications: what the radiologist needs to know. Radiographics 2016; 36 (01) 192-208
13 Scalise JJ, Miniaci A, Iannotti JP. Resurfacing arthroplasty of the humerus: indications, surgical technique, and clinical results. Tech Shoulder Elbow Surg 2007; 8 (03) 152-160
14 Bailie DS, Llinas PJ, Ellenbecker TS. Cementless humeral resurfacing arthroplasty in active patients less than fifty-five years of age. J Bone Joint Surg Am 2008; 90 (01) 110-117
15 Rugg CM, Coughlan MJ, Lansdown DA. Reverse total shoulder arthroplasty: biomechanics and indications. Curr Rev Musculoskelet Med 2019; 12 (04) 542-553
16 Gustas-French C, Petscavage-Thomas J, Bernard SA. Imaging of shoulder arthroplasties. AJR Am J Roentgenol 2018; 211 (03) 485-495
17 Jobin CM, Brown GD, Bahu MJ. et al. Reverse total shoulder arthroplasty for cuff tear arthropathy: the clinical effect of deltoid lengthening and center of rotation medialization. J Shoulder Elbow Surg 2012; 21 (10) 1269-1277
18 Saupe N, Pfirrmann CW, Schmid MR, Jost B, Werner CM, Zanetti M. Association between rotator cuff abnormalities and reduced acromiohumeral distance. AJR Am J Roentgenol 2006; 187 (02) 376-382
19 Moosikasuwan JB, Miller TT, Burke BJ. Rotator cuff tears: clinical, radiographic, and US findings. Radiographics 2005; 25 (06) 1591-1607
20 Pearl ML. Proximal humeral anatomy in shoulder arthroplasty: implications for prosthetic design and surgical technique. J Shoulder Elbow Surg 2005; 14 (1, Suppl S): 99S-104S
21 Vo KV, Hackett DJ, Gee AO, Hsu JE. Classifications in brief: Walch classification of primary glenohumeral osteoarthritis. Clin Orthop Relat Res 2017; 475 (09) 2335-2340
22 Nowak DD, Bahu MJ, Gardner TR. et al. Simulation of surgical glenoid resurfacing using three-dimensional computed tomography of the arthritic glenohumeral joint: the amount of glenoid retroversion that can be corrected. J Shoulder Elbow Surg 2009; 18 (05) 680-688
23 Strauss EJ, Roche C, Flurin PH, Wright T, Zuckerman JD. The glenoid in shoulder arthroplasty. J Shoulder Elbow Surg 2009; 18 (05) 819-833
24 Budge MD, Lewis GS, Schaefer E, Coquia S, Flemming DJ, Armstrong AD. Comparison of standard two-dimensional and three-dimensional corrected glenoid version measurements. J Shoulder Elbow Surg 2011; 20 (04) 577-583
25 Sharifi A, Siebert MJ, Chhabra A. How to measure glenoid bone stock and version and why it is important: a practical guide. Radiographics 2020; 40 (06) 1671-1683
26 Friedman RJ, Hawthorne KB, Genez BM. The use of computerized tomography in the measurement of glenoid version. J Bone Joint Surg Am 1992; 74 (07) 1032-1037 B
27 Siebert MJ, Chalian M, Sharifi A. et al. Qualitative and quantitative analysis of glenoid bone stock and glenoid version: inter-reader analysis and correlation with rotator cuff tendinopathy and atrophy in patients with shoulder osteoarthritis. Skeletal Radiol 2020; 49 (06) 985-993
28 Kuberakani K, Aizawa K, Yamamoto N. et al. Comparison of best-fit circle versus contralateral comparison methods to quantify glenoid bone defect. J Shoulder Elbow Surg 2020; 29 (03) 502-507
29 Sugaya H, Moriishi J, Dohi M, Kon Y, Tsuchiya A. Glenoid rim morphology in recurrent anterior glenohumeral instability. J Bone Joint Surg Am 2003; 85 (05) 878-884
30 Jacxsens M, Van Tongel A, Henninger HB, Tashjian RZ, De Wilde L. The three-dimensional glenohumeral subluxation index in primary osteoarthritis of the shoulder. J Shoulder Elbow Surg 2017; 26 (05) 878-887
31 Walch G, Badet R, Boulahia A, Khoury A. Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplasty 1999; 14 (06) 756-760
32 Fourneau T, van Haute E, De Wilde L, Van Tongel A, Van der Bracht H. 3D preoperative planning for shoulder arthroplasty: an evaluation of different planning software systems. Semin Arthroplasty 2022; 32 (03) 474-481
33 Omoumi P, Bafort AC, Dubuc JE, Malghem J, Vande Berg BC, Lecouvet FE. Evaluation of rotator cuff tendon tears: comparison of multidetector CT arthrography and 1.5-T MR arthrography. Radiology 2012; 264 (03) 812-822
34 Choate WS, Shanley E, Washburn R. et al. The incidence and effect of fatty atrophy, positive tangent sign, and rotator cuff tears on outcomes after total shoulder arthroplasty. J Shoulder Elbow Surg 2017; 26 (12) 2110-2116
35 Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res 1994; (304) 78-83
36 Schiefer M, Mendonça R, Magnanini MM. et al. Intraobserver and interobserver agreement of Goutallier classification applied to magnetic resonance images. J Shoulder Elbow Surg 2015; 24 (08) 1314-1321
37 Breighner RE, Endo Y, Konin GP, Gulotta LV, Koff MF, Potter HG. Technical developments: zero echo time imaging of the shoulder: enhanced osseous detail by using MR imaging. Radiology 2018; 286 (03) 960-966
38 Ensle F, Kaniewska M, Lohezic M, Guggenberger R. Enhanced bone assessment of the shoulder using zero-echo time MRI with deep-learning image reconstruction. Skeletal Radiol 2024
39 Cantarelli Rodrigues T, Deniz CM, Alaia EF. et al. Three-dimensional MRI bone models of the glenohumeral joint using deep learning: evaluation of normal anatomy and glenoid bone loss. Radiol Artif Intell 2020; 2 (05) e190116
40 Fischer CA, Weber MA, Neubecker C, Bruckner T, Tanner M, Zeifang F. Ultrasound vs. MRI in the assessment of rotator cuff structure prior to shoulder arthroplasty. J Orthop 2015; 12 (01) 23-30
41 Farooqi AS, Lee A, Novikov D. et al. Diagnostic accuracy of ultrasonography for rotator cuff tears: a systematic review and meta-analysis. Orthop J Sports Med 2021; 9 (10) 23 259671211035106
42 Wall LB, Teefey SA, Middleton WD. et al. Diagnostic performance and reliability of ultrasonography for fatty degeneration of the rotator cuff muscles. J Bone Joint Surg Am 2012; 94 (12) e83
43 Sperling JW, Hawkins RJ, Walch G, Zuckerman JD. Complications in total shoulder arthroplasty. J Bone Joint Surg Am 2013; 95 (06) 563-569
44 Combes D, Lancigu R, Desbordes de Cepoy P. et al. Imaging of shoulder arthroplasties and their complications: a pictorial review. Insights Imaging 2019; 10 (01) 90
45 Sheridan BD, Ahearn N, Tasker A, Wakeley C, Sarangi P. Shoulder arthroplasty. Part 2: normal and abnormal radiographic findings. Clin Radiol 2012; 67 (07) 716-721
46 Favard L, Berhouet J, Walch G, Chaoui J, Lévigne C. Superior glenoid inclination and glenoid bone loss: definition, assessment, biomechanical consequences, and surgical options. Orthopade 2017; 46 (12) 1015-1021
47 Pinkas D, Wiater B, Wiater JM. The glenoid component in anatomic shoulder arthroplasty. J Am Acad Orthop Surg 2015; 23 (05) 317-326
48 Gonzalez JF, Alami GB, Baque F, Walch G, Boileau P. Complications of unconstrained shoulder prostheses. J Shoulder Elbow Surg 2011; 20 (04) 666-682
49 Petscavage JM, Ha AS, Chew FS. Current concepts of shoulder arthroplasty for radiologists: Part 1—Epidemiology, history, preoperative imaging, and hemiarthroplasty. AJR Am J Roentgenol 2012; 199 (04) 757-767
50 Bohsali KI, Bois AJ, Wirth MA. Complications of shoulder arthroplasty. J Bone Joint Surg Am 2017; 99 (03) 256-269
51 Levine WN, Fischer CR, Nguyen D, Flatow EL, Ahmad CS, Bigliani LU. Long-term follow-up of shoulder hemiarthroplasty for glenohumeral osteoarthritis. J Bone Joint Surg Am 2012; 94 (22) e164-e17
52 Durchholz H, Salomonsson B, Moroder P. et al. Core set of radiographic parameters for shoulder arthroplasty monitoring: criteria defined by an international Delphi consensus process. JBJS Open Access 2019; 4 (04) e0025
53 Yian EH, Werner CML, Nyffeler RW. et al. Radiographic and computed tomography analysis of cemented pegged polyethylene glenoid components in total shoulder replacement. J Bone Joint Surg Am 2005; 87 (09) 1928-1936
54 Matsen III FA, Clinton J, Lynch J, Bertelsen A, Richardson ML. Glenoid component failure in total shoulder arthroplasty. J Bone Joint Surg Am 2008; 90 (04) 885-896
55 Boileau P. Complications and revision of reverse total shoulder arthroplasty. Orthop Traumatol Surg Res 2016; 102 (1, Suppl): S33-S43
56 Sanchez-Sotelo J, Wright TW, O'Driscoll SW, Cofield RH, Rowland CM. Radiographic assessment of uncemented humeral components in total shoulder arthroplasty. J Arthroplasty 2001; 16 (02) 180-187
57 Nagels J, Stokdijk M, Rozing PM. Stress shielding and bone resorption in shoulder arthroplasty. J Shoulder Elbow Surg 2003; 12 (01) 35-39
58 Sneag DB, Bogner EA, Potter HG. Magnetic resonance imaging evaluation of the painful total knee arthroplasty. Semin Musculoskelet Radiol 2015; 19 (01) 40-48
59 Chen KC, Chen JY. All about shoulder arthroplasty: what radiologists should know. Semin Musculoskelet Radiol 2019; 23 (02) 126-140
60 Konin GP. Imaging of shoulder arthroplasty. Semin Musculoskelet Radiol 2015; 19 (01) 49-59
61 Merolla G, Di Pietto F, Romano S, Paladini P, Campi F, Porcellini G. Radiographic analysis of shoulder anatomical arthroplasty. Eur J Radiol 2008; 68 (01) 159-169
62 Böhm E, Scheibel M, Lädermann A. Subscapularis insufficiency: what's all the fuss about?. J Shoulder Elbow Surg 2018;2 Available at: https://journals.sagepub.com/doi/pdf/10.1177/2471549218792370 Accessed September 20, 2024
63 Denard PJ, Lädermann A. Immediate versus delayed passive range of motion following total shoulder arthroplasty. J Shoulder Elbow Surg 2016; 25 (12) 1918-1924
64 Gerber C, Yian EH, Pfirrmann CA, Zumstein MA, Werner CM. Subscapularis muscle function and structure after total shoulder replacement with lesser tuberosity osteotomy and repair. J Bone Joint Surg Am 2005; 87 (08) 1739-1745
65 Miller BS, Joseph TA, Noonan TJ, Horan MP, Hawkins RJ. Rupture of the subscapularis tendon after shoulder arthroplasty: diagnosis, treatment, and outcome. J Shoulder Elbow Surg 2005; 14 (05) 492-496
66 Armstrong AD, Southam JD, Horne AH, Hollenbeak CS, Flemming DJ, Kothari MJ. Subscapularis function after total shoulder arthroplasty: electromyography, ultrasound, and clinical correlation. J Shoulder Elbow Surg 2016; 25 (10) 1674-1680
67 Ives EP, Nazarian LN, Parker L, Garrigues GE, Williams GR. Subscapularis tendon tears: a common sonographic finding in symptomatic postarthroplasty shoulders. J Clin Ultrasound 2013; 41 (03) 129-133
68 Roberts CC, Ekelund AL, Renfree KJ, Liu PT, Chew FS. Radiologic assessment of reverse shoulder arthroplasty. Radiographics 2007; 27 (01) 223-235
69 Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Molé D. Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Joint Surg Br 2004; 86 (03) 388-395
70 Nicholson GP, Strauss EJ, Sherman SL. Scapular notching: recognition and strategies to minimize clinical impact. Clin Orthop Relat Res 2011; 469 (09) 2521-2530
71 Athwal GS, Sperling JW, Rispoli DM, Cofield RH. Periprosthetic humeral fractures during shoulder arthroplasty. J Bone Joint Surg Am 2009; 91 (03) 594-603
72 Wright TW, Cofield RH. Humeral fractures after shoulder arthroplasty. J Bone Joint Surg Am 1995; 77 (09) 1340-1346
73 Gebrelul A, Green A, Schacherer T, Khazzam M. Periprosthetic humerus fractures: classification, management, and review of the literature. Ann Jt 2018; 3: 49-49
74 Neyton L, Erickson J, Ascione F, Bugelli G, Lunini E, Walch G. Grammont Award 2018: Scapular fractures in reverse shoulder arthroplasty (Grammont style): prevalence, functional, and radiographic results with minimum 5-year follow-up. J Shoulder Elbow Surg 2019; 28 (02) 260-267
75 Levy JC, Anderson C, Samson A. Classification of postoperative acromial fractures following reverse shoulder arthroplasty. J Bone Joint Surg Am 2013; 95 (15) e104-e107
76 Crosby LA, Hamilton A, Twiss T. Scapula fractures after reverse total shoulder arthroplasty: classification and treatment. Clin Orthop Relat Res 2011; 469 (09) 2544-2549
77 Wahlquist TC, Hunt AF, Braman JP. Acromial base fractures after reverse total shoulder arthroplasty: report of five cases. J Shoulder Elbow Surg 2011; 20 (07) 1178-1183
78 Singh JA, Sperling JW, Schleck C, Harmsen WS, Cofield RH. Periprosthetic infections after total shoulder arthroplasty: a 33-year perspective. J Shoulder Elbow Surg 2012; 21 (11) 1534-1541
79 Farshad M, Gerber C. Reverse total shoulder arthroplasty-from the most to the least common complication. Int Orthop 2010; 34 (08) 1075-1082
80 Love C, Marwin SE, Palestro CJ. Nuclear medicine and the infected joint replacement. Semin Nucl Med 2009; 39 (01) 66-78
81 Pruijn N, Heesakkers N, Kosse N, van der Pluijm M, Telgt D, Dorrestijn O. Better diagnostic value of tissue cultures obtained during mini-open and arthroscopic procedures compared with sterile punctures to identify periprosthetic shoulder infections: a retrospective cohort study. J Shoulder Elbow Surg 2022; 31 (05) 932-939
82 Ball CM. Neurologic complications of shoulder joint replacement. J Shoulder Elbow Surg 2017; 26 (12) 2125-2132
83 Lädermann A, Lübbeke A, Mélis B. et al. Prevalence of neurologic lesions after total shoulder arthroplasty. J Bone Joint Surg Am 2011; 93 (14) 1288-1293
84 Vajapey SP, Contreras ES, Cvetanovich GL, Neviaser AS. Neurologic complications in primary anatomic and reverse total shoulder arthroplasty: a review. J Clin Orthop Trauma 2021; 20: 101475