The effects of subpectoral and prepectoral implant reconstruction on upper extremity functionality, range of motion, and proprioception in patients with breast cancer

Abstract

Shoulder pain and decreased glenohumeral joint movement are commonly observed after surgery. The aim of the present study was to evaluate upper extremity functionality, shoulder joint range of motion, and shoulder proprioception in patients who underwent subpectoral and prepectoral implant reconstruction. This study was designed as a cross-sectional study. A total of 80 female patients were included in the study (subpectoral implant surgery, n = 28; prepectoral implant surgery, n = 28; control group, n = 24). Patients who had undergone subpectoral or prepectoral implant reconstruction surgery at least 3 months prior were included in the evaluation. Participants’ upper extremity functional levels were assessed using the DASH; the active normal range of motion of the shoulder joint was measured with a universal goniometer; and shoulder joint proprioception was evaluated with a “Clinometer.” No significant differences were found between subpectoral and prepectoral implant reconstruction regarding DASH, ROM, and 45°-75° ER proprioception ( p > 0.05). However, there was a significant difference between healthy and surgically treated female participants ( p < 0.05). Proprioception values for the 45° IR angle were significantly different between surgery groups and healthy female groups ( p < 0.05). Breast reconstruction surgery had negative effects on upper extremity functionality and normal joint range of motion, which persisted three months post-surgery. However, no significant difference was found between the commonly used SIS and PIS methods. While shoulder joint proprioception was not negatively affected in women who underwent PIS, women who underwent SIS experienced impaired proprioception at the 45° IR angle.