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Reverse Total Shoulder Arthroplasty Improves Function in Cuff Tear Arthropathy

  • Symposium: Reverse Total Shoulder Arthroplasty
  • Published:
Clinical Orthopaedics and Related Research®

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.

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Acknowledgments

We thank Mamtha Balasubramaniam, Senior Biostatistician, for help in statistical analysis.

Author information

Authors and Affiliations

  1. Indiana University School of Medicine, Indiana University, 541 Clinical Drive, Suite 600, Indianapolis, IN, 46202, USA

    Betsy M. Nolan MD

  2. William Beaumont School of Medicine, William Beaumont Hospital, Oakland University, 3535 West Thirteen Mile Road, Suite 744, Royal Oak, MI, 48073, USA

    Elizabeth Ankerson BS & J. Michael Wiater MD

Authors
  1. Betsy M. Nolan MD
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  2. Elizabeth Ankerson BS
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  3. J. Michael Wiater MD
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Corresponding author

Correspondence to J. Michael Wiater MD.

Additional information

One or more of the authors (JMW) is a paid consultant, and he or she has or may receive payments or benefits from a commercial entity related to this work (Zimmer Inc., Warsaw, IN). This study was funded by a grant from the William Beaumont Hospital Research Institute.

Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Nolan, B.M., Ankerson, E. & Wiater, J.M. Reverse Total Shoulder Arthroplasty Improves Function in Cuff Tear Arthropathy. Clin Orthop Relat Res 469, 2476–2482 (2011). https://doi.org/10.1007/s11999-010-1683-z

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  • DOI: https://doi.org/10.1007/s11999-010-1683-z

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