Preparing for the bundled-payment initiative: the cost and clinical outcomes of reverse shoulder arthroplasty for the surgical treatment of advanced rotator cuff deficiency at an average 4-year follow-up

2013 ◽  
Vol 22 (12) ◽  
pp. 1612-1622 ◽  
Author(s):  
Nazeem A. Virani ◽  
Christopher D. Williams ◽  
Rachel Clark ◽  
John Polikandriotis ◽  
Katheryne L. Downes ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Bundled Payment ◽  
Rotator Cuff Deficiency ◽  
The Cost

The 4-year Cost and Clinical Outcomes of Reverse Shoulder Arthroplasty for the Surgical Treatment of the Rotator Cuff Deficient Shoulder

2013 ◽  
Vol 22 (10) ◽  
pp. e34-e35
Author(s):  
Nazeem A. Virani ◽  
Chris D. Williams ◽  
Rachel Clark ◽  
John Polikandriotis ◽  
Katheryne L. Downes ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty

Prospective comparison of functional outcomes of primary reverse shoulder arthroplasty for acute fractures versus rotator cuff deficiencies

2020 ◽  
Vol 102-B (11) ◽  
pp. 1555-1559
Author(s):  
Emilio Sebastia-Forcada ◽  
Alejandro Lizaur-Utrilla ◽  
Gerard Mahiques-Segura ◽  
Matias Ruiz-Lozano ◽  
Fernando Anacleto Lopez-Prats ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Functional Outcomes ◽  
Proximal Humeral Fracture ◽  
Revision Rate ◽  
Reverse Shoulder Arthroplasty ◽  
Humeral Fracture ◽  
Fracture Group ◽  
Rotator Cuff Deficiency

Aims The purpose of this study was to determine whether there were long-term differences in outcomes of reverse shoulder arthroplasty (RSA) undertaken for acute proximal humeral fracture versus rotator cuff deficiency with a minimum follow-up of five years. Methods This was a prospective cohort study comparing 67 patients with acute complex proximal humeral fracture and 64 patients with irreparable rotator cuff deficiency who underwent primary RSA. In the fracture group, there were 52 (77.6%) females and 15 (22.4%) males, with a mean age of 73.5 years (51 to 85), while in the arthropathy group, there were 43 (67.1%) females and 21 (32.9%) males, with a mean age of 70.6 years (50 to 84). Patients were assessed by the Constant score, University of California Los Angeles shoulder score (UCLA), short version of the Disability of the Arm Shoulder and Hand score (QuickDASH), and visual analogue scales (VAS) for pain and satisfaction. Radiological evaluation was also performed. Results Mean follow-up was 8.4 years (5 to 11). There were no significant differences in mean absolute (p = 0.125) or adjusted (p = 0.569) Constant, UCLA (p = 0.088), QuickDASH (p = 0.135), VAS-pain (p = 0.062), or range of movement at the final follow-up. However, patient satisfaction was significantly lower in the fracture group (p = 0.002). The complication rate was 1.5% (one patient) versus 9.3% (six patients), and the revision rate was 1.5% (one patient) versus 7.8% (five patients) in the fracture and arthropathy groups, respectively. The ten-year arthroplasty survival was not significantly different (p = 0.221). Conclusion RSA may be used not only for patients with irreparable rotator cuff deficiencies, but also for those with acute complex proximal humeral fractures. We found that RSA provided similar functional outcomes and a low revision rate for both indications at long-term. However, satisfaction is lower in patients with an acute fracture. Cite this article: Bone Joint J 2020;102-B(11):1555–1559.

Reverse Shoulder Arthroplasty for the Treatment of Rotator Cuff Deficiency

2017 ◽  
Vol 99 (22) ◽  
pp. 1895-1899 ◽  
Author(s):  
Derek J. Cuff ◽  
Derek R. Pupello ◽  
Brandon G. Santoni ◽  
Rachel E. Clark ◽  
Mark A. Frankle
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Rotator Cuff Deficiency

Reverse Shoulder Arthroplasty for the Treatment of Rotator Cuff Deficiency

2012 ◽  
Vol 94 (21) ◽  
pp. 1996-2000 ◽  
Author(s):  
Derek Cuff ◽  
Rachel Clark ◽  
Derek Pupello ◽  
Mark Frankle
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Rotator Cuff Deficiency

scholarly journals Is limited external rotation after reverse shoulder arthroplasty associated with glenoidal notching?

2021 ◽  
Author(s):  
Alexandra Grob ◽  
Samy Bouaicha ◽  
Marco Germann ◽  
Sabra Germann ◽  
Christian Gerber ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Radiographic Progression ◽  
External Rotation ◽  
Constant Score ◽  
Reverse Shoulder Arthroplasty ◽  
Scapular Notching ◽  
Cuff Tear ◽  
Over Time

Abstract Background Reverse shoulder arthroplasty (RSA) is a valuable solution for patients with shoulder pain or injury primarily due to a rotator cuff tear or secondary to traumatic events. Nevertheless, several complications are known to appear, with the most frequent being scapular notching (SN) on the inferior and posterior scapular neck. Controversial data exist about the clinical relevance of SN. Since further consequences are still not clearly understood, we aimed to provide more clarity on which factors, especially external rotation (ER), contribute to the appearance and progress of notching. Methods Constant Score (CS), Subjective Shoulder Value (SSV), flexion, abduction, and ER were evaluated retrospectively in 153 shoulders of 147 patients (mean age 79±7.7 years; 62% women) who underwent RSA between 2005 and 2010. Anteroposterior radiographs were evaluated before and 1, 2, 3, and 5 years after RSA for SN according to the Sirveaux classification. The evaluation was performed by two independent surgeons. Spearman’s coefficient and t-test were used. Results CS, SSV, flexion, and abduction increased significantly 1 year after RSA compared to before (all p < 0.0001). No improvement was shown for ER between the same timepoints. Between 2 and 5 years of follow-up, only flexion decreased by 5°(p = 0.02) while CS, SSV, abduction, and ER remained constant. After RSA, notching increases over time. There was no association between SN and CS, SSV, flexion, abduction or ER at any of the measured timepoints. Higher flexion correlated with higher abduction after RSA at every follow-up (1 year r = 0.88, 2 years r = 0.89, 3 years r = 0.86, 5 years r = 0.86). The interrater correlation test showed a strong correlation (r = 0.7). Conclusion We verified the functional benefits of RSA for patients. Additionally, our findings show that despite radiographic progression of notching and unchanged limited ER, the postoperative improvements in CS, SSV, flexion, and abduction are preserved over 5 years.

scholarly journals Long-term outcome of arthroscopic debridement of massive irreparable rotator cuff tears

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241277
Author(s):  
Tim Vogler ◽  
Dimosthenis Andreou ◽  
Georg Gosheger ◽  
Nico Kurpiers ◽  
Clara Velmans ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Rotator Cuff Tears ◽  
Arthroscopic Debridement ◽  
Radiographic Outcome ◽  
Vas Score ◽  
Long Term Follow Up

Objectives To evaluate the clinical and radiographic outcome of low-demand patients with massive rotator cuff tears undergoing arthroscopic debridement in mid- and long-term follow-up, as well as the rate of conversion to reverse shoulder arthroplasty. Methods We performed a retrospective analysis of 19 patients with a mean age at surgery of 68 years (range, 55–80 years) from a previously described consecutive cohort and after a mean follow up of 47 month (FU1) and 145 month (FU2). The functional outcome was evaluated with the VAS score, the American Shoulder and Elbow Surgeons (ASES) score, and the age- and gender-adjusted Constant (aCS) score. The radiographic outcome was classified according to the Hamada classification. Non-parametric analyses were carried out with the Mann-Whitney U for independent samples and the Wilcoxon signed-rank test for related samples. Results Five patients (26%) developed symptomatic cuff tear arthropathy and underwent reverse shoulder arthroplasty after a mean time of 63 months (range, 45–97 months). These patients were excluded from further analyses. The mean VAS score of the remaining 14 patients at FU1 was significantly lower compared to preoperatively (P = .041), while there were no significant differences between the VAS score at FU1 and FU2 (P = 1.0). The ASES score of the affected shoulder at FU1 was significantly higher compared to prior to surgery (P = .028), while there were no significant differences between the scores of the affected shoulder between FU1 and FU2 (P = .878). While the ASES score of the contralateral shoulder at FU1 was significantly higher than the score of the affected shoulder (P = .038), there were no significant differences in the ASES scores of the affected and the healthy shoulder at FU2 (P = .575). The evaluation of the aCS produced similar results. A progression of the Hamada grade was documented in 6 patients. Conclusions Arthroscopic debridement is a safe and valid option for low-demand middle-age or elderly patients with symptomatic massive rotator cuff tears, leading to a significant pain relief and significantly improved functional outcome at mid- and long-term follow up. However, about a quarter of the patients in our cohort had to undergo reverse shoulder arthroplasty due to symptomatic cuff tear arthropathy. Furthermore, some of the remaining patients continued to undergo radiographic progression. This might be due to the natural history of their disease and/or the surgical procedure, and the clinical relevance of this finding should be evaluated in further studies.

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