Shoulder joint angles in supine and upright imaging of the pre-operative reverse total shoulder arthroplasty patient

Page 1 of 4 ArƟcle Title: Shoulder joint angles in supine and upright imaging of the pre-operaƟve reverse total shoulder arthroplasty paƟent CitaƟon: JSES Reviews, Reports, and Techniques, (hƩps://pubmed.ncbi.nlm.nih.gov/41179466/) JSES RR&T DOI: hps://doi.org/10.1016/j.xrrt.2025.08.006 Zenodo DOI: hps://doi.org/10.5281/zenodo.17042123  Henninger Lab, Harold K. Dunn Orthopaedic Research Laboratory University of Utah, Salt Lake City, UT hƩps://medicine.utah.edu/orthopaedics/research/labs/harold-dunn/groups/henninger This code analyzes scapulothoracic and glenohumeral joint angles from subjects pre-operave to reverse total shoulder arthroplasty (rTSA) using anatomic landmark data from supine CT scans and upright seated biplane fluoroscopy/opcal moon capture. Anatomical coordinate systems for the torso, scapula, and humerus are defined based on landmark posions, guided by ISB recommendaons (hps://pubmed.ncbi.nlm.nih.gov/15844264/) but with variances to generate consistent analyses unaffected by posture and limitaons of clinical medical imaging. Notably, the sternum is used as the definive thorax Y-axis as it should be self-consistent between both supine and upright data collecons. The data is formaed in the same manner as prior releases of data from: - healthy shoulders (hƩps://doi.org/10.5281/zenodo.14889478) - shoulders aer rTSA (hƩps://doi.org/10.5281/zenodo.16537557) Of note, supine and upright data herein arose from some of the same subjects presented in the prior repository of rTSA subjects (e.g., Reverse_012, _013, _015, _016, _017, _018, and _019). The present study used stac resng neutral data from the pre-operave visit (i.e., 00wk) which was not available in the prior release (but is included herein). A full release of pre-operave kinemacs for 00wk is planned for later in 2025 and will be versioned in the prior rTSA repository. Data contained in the present repository provide only deidenfied anatomic landmarks (in Cartesian coordinates). Source DICOMs and 3D bone surface models may be available upon request. File naming convenƟon Group_subject ID#_sex_age_side_acvity_trial#_data i. E.g., Reverse_002_F_64_R_stac_t01_output.xlsx – a subject with Reverse total shoulder arthroplasty, subject #2, that is Female, 64 years old, Right side imaged, in the stac resng neutral pose, during trial #1, and this file contains all data relevant to the subject and acvity ii. Stac poses were captured in a resng neutral pose while seated upright, with elbows flexed 90 degrees, hands forward, thumbs up iii. Note: Subjects have the addional qualifier “_00wk”. These subjects were part of a study that collected both pre- (00wk) and post-op (e.g., 52wk) mepoints. Page 2 of 4 Provided Data Files CT Landmarks.xlsx A spreadsheet containing the supine anatomical landmarks as measured from 3D reconstrucons of the bones in CT. Herein the necessary landmarks included: Torso - SN – sternal notch - XP – xyphoid process (or distal sternal bisector [SB] if XP not visible) - C7 – process of the C7 vertebra Scapula - TS – trigonum spinae - IA – distal p of the inferior angle - GSC – post-operave glenosphere center (could substute the glenoid center if this is available in otherwise healthy scapulae) Humerus - LT – lesser tuberosity of the humerus - SCT – sha cylinder, top - SCB – sha cylinder, boom *_output.xlsx Spreadsheet containing the anatomical landmarks as measured from markerless tracking of biplane fluoroscopy/dynamic stereoradiography data. These sheets follow the format of prior repositories on Zenodo.org, with sheets for demographics (sheet1), scapular landmarks (scapula), humeral landmarks (humerus), and marker-based opcal tracking of anatomic landmarks (vicon). Provided MATLAB Files (requires MATLAB R2021a or later) a1_CreateTorsoCS.m Script to transform raw data into the torso coordinate systems (runs on individual subject data) a2_CreateScapCS.m Script to transform data within torso coordinate systems to the scapula coordinate systems (runs on individual subject data) a3_ST_joint_angles.m Script to calculate scapulothoracic joint angles from data within the torso coordinate systems (runs as a batch on all subjects in the folder) a4_GH_joint_angles.m Script to calculate glenohumeral joint angles from data within the scapula coordinate systems (runs as a batch on all subjects in the folder) a5_sternumanalysis.m Script to calculate the synthec xiphoid process (XP) axis from sternal bisector (SB) in supine CT (create and reformat data into the file "CT Landmarks – Corrected XP.xlsx"). a6_CTAnalysis.m Script to compare supine and upright joint angles (includes all relevant calculaons of supine joint angles from CT within – steps a3 and a4 do the same for the upright joint angles). torso_cs.m Funcon that creates torso coordinate system for upright data torso_cs_ct.m Funcon that creates torso coordinate system for supine data. The only difference to torso_cs.m is that there is no looping of the calculaon. Page 3 of 4 scapula_cs.m Funcon that creates scapula coordinate system for upright data scapula_cs_ct.m Funcon that creates scapula coordinate system for supine data. The only difference to scapula_cs.m is that there is no looping of the calculaon. humerus_cs.m Funcon that creates humerus coordinate system for upright data humerus_cs_ct.m Funcon that creates humerus coordinate system for supine data. The only difference to humerus_cs.m is that there is no looping of the calculaon. Folders used by the code Upright input files/00wk/ Contains input files of anatomic landmarks from subjects in the upright seated resng neutral posture at the pre-operave (00wk) mepoint Torso CS Points/00wk/ Contains files of anatomic landmarks recast into the torso CS at the preoperave (00wk) mepoint Scap CS Points/00wk/ Contains files of anatomic landmarks recast into the scapula CS at the preoperave (00wk) mepoint Joint Angles/00wk/ Contains files of scapulothoracic (ST) and glenohumeral (GH) joint angles created using the YXZ and XZY Cardan sequences, respecvely at the preoperave (00wk) mepoint InstrucƟons 1. Run a1_CreateTorsoCS.m 2. Run a2_CreateScapCS.m 3. Run a3_ST_joint_angles.m 4. Run a4_GH_joint_angles.m 5. Run a5_sternumanalysis.m 6. Run a6_CTanalysis.m Data and code provided in this repository were generated with support from the NaƟonal InsƟtute of ArthriƟs and Musculoskeletal and Skin Diseases (NIAMS) of the NaƟonal InsƟtutes of Health under award numbers R01 and R56 AR067196, and a Shared InstrumentaƟon Grant S10 OD021644. Refer to the following publicaons for detailed methods of data collecon and prior analyses using data from this repository in studies performed by our team: 1. Kolz CW, Sulkar HJ, Aliaj K, Tashjian RZ, Chalmers PN, Qiu Y, Zhang Y, Foreman KB, Anderson AE, Henninger HB. Reliable interpretaon of scapular kinemacs depends on coordinate system definion. Gait Posture. 2020 Sep;81:183-190. doi: 10.1016/j.gaitpost.2020.07.020. Epub 2020 Jul 25. PMID: 32758918; PMCID: PMC7484087. 2. Kolz CW, Sulkar HJ, Aliaj K, Tashjian RZ, Chalmers PN, Qiu Y, Zhang Y, Bo Foreman K, Anderson AE, Henninger HB. Age-related differences in humerothoracic, scapulothoracic, and glenohumeral kinemacs during elevaon and rotaon moons. J Biomech. 2021 Mar 5;117:110266. doi: 10.1016/j.jbiomech.2021.110266. Epub 2021 Jan 23. PMID: 33517243; PMCID: PMC7924070. Page 4 of 4 3. Aliaj K, Foreman KB, Chalmers PN, Henninger HB. Beyond Euler/Cardan analysis: True glenohumeral axial rotaon during arm elevaon and rotaon. Gait Posture. 2021 Jul;88:28-36. doi: 10.1016/j.gaitpost.2021.05.004. Epub 2021 May 8. PMID: 33989999; PMCID: PMC8316370. 4. Aliaj K, Henninger HB. Kinemacs-vis: A Visualizaon Tool for the Mathemacs of Human Moon. J Open Source Sow. 2021;6(68):3490. doi: 10.21105/joss.03490. Epub 2021 Dec 21. PMID: 35079685; PMCID: PMC8786220. 5. Sulkar HJ, Zitnay JL, Aliaj K, Henninger HB. Proximal humeral coordinate systems can predict humerothoracic and glenohumeral kinemacs of a full bone system. Gait Posture. 2021 Oct;90:380387. doi: 10.1016/j.gaitpost.2021.09.180. Epub 2021 Sep 20. PMID: 34564010; PMCID: PMC8585709. 6. Aliaj K, Lawrence RL, Bo Foreman K, Chalmers PN, Henninger HB. Kinemac coupling of the glenohumeral and scapulothoracic joints generates humeral axial rotaon. J Biomech. 2022 May;136:111059. doi: 10.1016/j.jbiomech.2022.111059. Epub 2022 Mar 24. PMID: 35367838; PMCID: PMC9081276. 7. Knighton TW, Chalmers PN, Sulkar HJ, Aliaj K, Tashjian RZ, Henninger HB. Anatomic total shoulder glenoid component inclinaon affects glenohumeral kinecs during abducon: a cadaveric study. J Shoulder Elbow Surg. 2022 Oct;31(10):2023-2033. doi: 10.1016/j.jse.2022.03.028. Epub 2022 May 10. PMID: 35550434; PMCID: PMC9481675. 8. Knighton TW, Chalmers PN, Sulkar HJ, Aliaj K, Tashjian RZ, Henninger HB. Reverse total shoulder glenoid component inclinaon affects glenohumeral kinecs during abducon: a cadaveric study. J Shoulder Elbow Surg. 2022 Dec;31(12):2647-2656. doi: 10.1016/j.jse.2022.06.016. Epub 2022 Aug 2. PMID: 35931329; PMCID: PMC9669184. 9. Sulkar HJ, Knighton TW, Amoafo L, Aliaj K, Kolz CW, Zhang Y, Hermans T, Henninger HB. In Vitro Simulaon of Shoulder Moon Driven by Three-Dimensional Scapular and Humeral Kinemacs. J Biomech Eng. 2022 May 1;144(5):051008. doi: 10.1115/1.4053099. PMID: 34817051; PMCID: PMC8822462. 10. Sulkar HJ, Aliaj K, Tashjian RZ, Chalmers PN, Foreman KB, Henninger HB. Reverse Total Shoulder Arthroplasty Alters Humerothoracic, Scapulothoracic, and Glenohumeral Moon During Weighted Scapon. Clin Orthop Relat Res. 2022 Nov 1;480(11):2254-2265. doi: 10.1097/CORR.0000000000002321. Epub 2022 Jul 20. PMID: 35857295; PMCID: PMC9555951. 11. Sulkar HJ, Aliaj K, Tashjian RZ, Chalmers PN, Foreman KB, Henninger HB. High and low performers in internal rotaon aer reverse total shoulder arthroplasty: a biplane fluoroscopic study. J Shoulder Elbow Surg. 2023 Apr;32(4):e133-e144. doi: 10.1016/j.jse.2022.10.009. Epub 2022 Nov 5. PMID: 36343789; PMCID: PMC10023281. 12. Zitnay JL, Tashjian RZ, Walch G, Chalmers PN, Joyce CD, Henninger HB. Inlay vs. onlay humeral components in reverse total shoulder arthroplasty: a bioroboc shoulder simulator study. J Shoulder Elbow Surg. 2024 Jun;33(6):1377-1386. doi: 10.1016/j.jse.2023.10.015. Epub 2023 Nov 28. PMID: 38036254; PMCID: PMC11098709. 13. Zitnay JL, Stout MR, Percin B, Tashjian RZ, Chalmers PN, Joyce CD, Walch G, Henninger HB. Isolated humeral distalizaon in reverse total shoulder arthroplasty: a bioroboc shoulder simulator study. J Shoulder Elbow Surg. 2025 May;34(5):1280-1290. doi: 10.1016/j.jse.2024.07.055. Epub 2024 Oct 5. PMID: 39369948; PMCID: PMC11971388.