The effect of lateralization on clinical outcomes after anatomic total shoulder arthroplasty
Bibliographic record
Abstract
BACKGROUND: Lateralization has been previously studied for reverse shoulder arthroplasty, but there is little clinical research investigating the independent effect of medialization or lateralization of the joint line, nor global medialization or lateralization for anatomic total shoulder arthroplasty (TSA). The goal of this study was to assess the impact of lateralization on clinical outcomes after anatomic TSA. METHODS: A retrospective review of a multi-institutional registry was performed. All anatomic TSAs with postoperative radiographs and minimum 2-year clinical outcomes were included. Six measurements were made on postoperative radiographs: (1) humeral center of rotation (COR) shift from ideal, (2) acromion to glenoid distance, (3) glenoid to greater tuberosity distance, (4) acromion to greater tuberosity distance, (5) lateralization shoulder angle, and (6) critical shoulder angle. Linear regression analyses were performed to evaluate any associations between radiographic measures and patient reported outcomes, range of motion (ROM), and strength. RESULTS: A total of 357 patients were included, of which mean age was 65 years and 61% were male. For PROs, the COR (P = .002) was significantly associated with the American Shoulder and Elbow Surgeons score. Additionally, COR was significantly associated with the Western Ontario Osteoarthritis of the Shoulder score. For ROM, COR shift was the only radiographic measure with a significant association with forward flexion (P = .002). Other significant associations with ROM in the regressions were: use of computed tomography based preoperative planning (forward flexion) and preoperative ROM. The acromion to glenoid distance distance (P = .008) and glenoid to greater tuberosity distance (P = .002) were both significantly associated with external rotation strength. CONCLUSIONS: Increasing humeral COR shift negatively impacts PROs and ROM after anatomic TSA regardless of the joint line position. Increased glenoid lateralization and increased global lateralization were associated with increased ER strength.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".