Journal of Shoulder and Elbow Surgery

Comparing daily shoulder motion and frequency after anatomic and reverse shoulder arthroplasty

Published:November 10, 2017DOI:


      Both anatomic (TSA) and reverse total shoulder arthroplasty (RTSA) are common interventions for glenohumeral arthrosis, with the goal of relieving pain and restoring mobility. Understanding shoulder arthroplasty motion and frequency is of interest in evaluating effectiveness and in predicting bearing wear for implant development and optimization. The purpose of this study was to measure and compare the total daily shoulder motion of patients after TSA and RTSA.


      Thirty-six human subjects who had undergone shoulder arthroplasty wore a custom instrumented garment that tracked upper extremity motion for the waking hours of 1 day. The 3-dimensional orientation of each humeral sensor was transformed with respect to the torso to calculate total joint motion and frequency, with comparison of TSA to RTSA. In addition, the yearly motion of the shoulder was extrapolated.


      The majority of shoulder motion occurred below 80° of elevation (P < .001), totaling on average 821 ± 45 and 783 ± 27 motions per hour for TSA and RTSA, respectively. Conversely, elevations >80° were significantly less frequent, totaling only 52 ± 44 (P < .001) and 38 ± 27 (P < .001) motions per hour for TSA and RTSA, respectively. No significant differences were detected between TSA and RTSA shoulders (P = .22) or their respective contralateral asymptomatic sides (P = .64, P = .62). When extrapolated, it was estimated that each TSA and RTSA shoulder elevated above 60° approximately 1 million and 0.75 million cycles per year, respectively.


      Mean shoulder motions after TSA or RTSA were not significantly different from the contralateral asymptomatic side. In addition, no significant differences were detected in shoulder motion or frequency between TSA and RTSA.

      Level of evidence


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic and Personal
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Shoulder and Elbow Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Coley B.
        • Jolles B.M.
        • Farron A.
        • Aminian K.
        Arm position during daily activity.
        Gait Posture. 2008; 28: 581-587
        • Drake G.N.
        • O'Conner D.
        • Edwards T.B.
        Indications for reverse total shoulder arthroplasty in rotator cuff disease.
        Clin Orthop Relat Res. 2010; 468: 1526-1533
        • Hurd W.J.
        • Morrow M.M.
        • Miller E.J.
        • Adams R.A.
        • Sperling J.W.
        • Kaufman K.R.
        Novel approaches to objectively assess shoulder function.
        J Shoulder Elbow Surg. 2014; 23: e251-e255
        • Maier M.W.
        • Caspers M.
        • Zeifang F.
        • Dreher T.
        • Klotz M.C.
        • Wolf S.I.
        • et al.
        How does reverse shoulder replacement change the range of motion in activities of daily living in patients with cuff tear arthropathy? A prospective optical 3D motion analysis study.
        Arch Orthop Trauma Surg. 2014; 39: 1199-1216
        • Maier M.W.
        • Kasten P.
        • Niklasch M.
        • Dreher T.
        • Zeifang F.
        • Rettig O.
        • et al.
        3D motion capture using the HUX model for monitoring functional changes with arthroplasty in patients with degenerative osteoarthritis.
        Gait Posture. 2014; 39: 7-11
        • Matthews C.E.
        • Chen K.Y.
        • Freedson P.S.
        • Buchowski M.S.
        • Beech M.
        • Pate R.R.
        • et al.
        Amount of time spent in sedentary behaviors in the United States, 2003-2004.
        Am J Epidemiol. 2008; 167: 875-881
        • Nolan B.M.
        • Ankerson E.
        • Wiater J.M.
        Reverse total shoulder arthroplasty improves function in cuff tear arthropathy.
        Clin Orthop Relat Res. 2011; 469: 2476-2482
        • Norris T.R.
        • Iannotti J.P.
        Functional outcome after shoulder arthroplasty for primary osteoarthritis: a multicenter study.
        J Shoulder Elbow Surg. 2002; 11: 130-135
        • Zhou H.
        • Hu H.
        • Harris N.D.
        • Hammerton J.
        Applications of wearable inertial sensors in estimation of upper limb movements.
        Biomed Signal Process Control. 2006; 1: 22-32
        • Zhou H.
        • Hu H.
        • Tao Y.
        Inertial measurements of upper limb motion.
        Med Biol Eng Comput. 2006; 44: 479-487
        • Zhou H.
        • Stone T.
        • Hu H.
        • Harris N.
        Use of multiple wearable inertial sensors in upper limb motion tracking.
        Med Eng Phys. 2008; 30: 123-133