Reverse total shoulder arthroplasty improves function in cuff tear arthropathy

  • B.M. N
  • E. A
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Abstract

Background Early failure due to glenoid loosening with anatomic total shoulder arthroplasty in patients with severe rotator cuff deficiency led to the development of the reverse ball-and-socket shoulder prosthesis. The literature reports improved short-term pain and function scores following modern reverse total shoulder arthroplasty (RTSA) in patients with cuff tear arthropathy (CTA). Questions/purposes We therefore sought to confirm previously reported short-term improvements in pain, function scores, and range of motion, in patients treated with RTSA for CTA and to identify clinical complications and radiographic notching. Methods We retrospectively reviewed 67 patients who underwent 71 primary RTSAs for CTA. The average age was 74 years (range, 54-92 years). All were preoperatively and postoperatively assessed using Constant-Murley and American Shoulder and Elbow Society (ASES) scores. We identified complications and examined radiographs for notching. The minimum followup was 12 months (average, 24 months; range, 12-58 months). Results Average Constant-Murley scores improved from 28 preoperatively to 62 postoperatively. Average ASES scores improved from 26 to 76. Subjective Shoulder Value (SSV) improved from 23 to 77. Active forward flexion improved from 61 preoperatively (range, 0-137) to 121 postoperatively (range, 52-170). Active external rotation was not affected. Thirty-five of the 71 shoulders (49%) showed radiographic notching. The overall complication rate was 23%. No patient required reoperation. One patient required closed reduction of a perioperative dislocation. Conclusions RTSA for CTA results in functional improvement, with a low complication rate. However, the longevity of the device is currently unknown. Level of Evidence Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. © 2011 The Association of Bone and Joint Surgeons.

Author-supplied keywords

  • *osteoarthropathy/su [Surgery]
  • *reverse shoulder arthroplasty
  • *rotator cuff rupture/su [Surgery]
  • adult
  • aged
  • clinical assessment
  • conference paper
  • controlled study
  • female
  • follow up
  • fracture nonunion/co [Complication]
  • fracture reduction
  • functional assessment
  • human
  • humerus fracture/co [Complication]
  • iatrogenic disease/co [Complication]
  • lung embolism/co [Complication]
  • major clinical study
  • male
  • mononeuropathy/co [Complication]
  • pain assessment
  • peroperative complication/co [Complication]
  • pneumonia/co [Complication]
  • postoperative complication/co [Complication]
  • postoperative period
  • preoperative evaluation
  • priority journal
  • range of motion
  • renal artery thrombosis/co [Complication]
  • retrospective study
  • scoring system
  • shoulder dislocation/co [Complication]
  • shoulder dislocation/su [Surgery]
  • shoulder fracture/co [Complication]
  • shoulder radiography
  • spine fracture/co [Complication]

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Authors

  • Nolan B.M.

  • Ankerson E.

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