Ten years of reverse total shoulder arthroplasty performed for osteoarthritis and intact rotator cuff: indications and outcomes

2017 ◽  
Vol 26 (5) ◽  
pp. e159 ◽  
Author(s):  
Jonathan J. Streit ◽  
Jonathan C. Clark ◽  
Jesse Allert ◽  
Rachel Clark ◽  
Kaitlyn N. Christmas ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder

Effect of deltoid volume on range of motion and patient-reported outcomes following reverse total shoulder arthroplasty in rotator cuff-intact and rotator cuff-deficient conditions

2020 ◽  
pp. 175857322092504
Author(s):  
Samuel G McClatchy ◽  
Griffin M Heise ◽  
William M Mihalko ◽  
Frederick M Azar ◽  
Richard A Smith ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Patient Reported Outcomes ◽  
Total Shoulder Arthroplasty ◽  
Deltoid Muscle ◽  
Reverse Total Shoulder Arthroplasty ◽  
Shoulder Range Of Motion ◽  
Patient Reported ◽  
Reverse Total Shoulder

Background Deltoid muscle function is paramount to the success of reverse total shoulder arthroplasty. The purpose of this study was to investigate the role of deltoid volume on shoulder range of motion and patient-reported outcomes following reverse total shoulder arthroplasty in rotator cuff-intact and rotator cuff-deficient conditions. Methods Retrospective review of records identified 107 patients who met inclusion criteria. The rotator cuff integrity was evaluated by two musculoskeletal-trained radiologists. Volumetric deltoid measurements were calculated from preoperative computed tomography or magnetic resonance imaging scans. Satisfactory outcomes were defined as forward elevation of at least 135°, external rotation of at least 35°, and American Shoulder and Elbow Surgeons and Single Assessment Numerical Evaluation scores of at least 70. Results Mean total deltoid muscle volume was significantly higher in patients with satisfactory forward elevation (57.8 ± 18.1 cm³) versus unsatisfactory forward elevation (48.6 ± 19.5 cm³) (p = 0.013). When separated by rotator cuff integrity, total deltoid volume was significantly higher (p = 0.030) in patients who achieved satisfactory forward elevation in the rotator cuff-deficient group but not the rotator cuff-intact group (p = 0.533). Discussion Preoperative deltoid volume directly correlated with achieving satisfactory forward elevation after reverse total shoulder arthroplasty in rotator cuff-deficient conditions and may be one factor in determining the ability to achieve satisfactory outcomes in the rotator cuff-deficient patient.

Strain Analysis in the Scapula After a Reverse Total Shoulder Arthroplasty

2012 ◽  
Author(s):  
Radhika J. Patel ◽  
Chi Zhang ◽  
Yingxin Gao
Keyword(s):  
Articular Cartilage ◽  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Cartilage Damage ◽  
Strain Analysis ◽  
Reverse Total Shoulder Arthroplasty ◽  
Articular Cartilage Damage ◽  
Reverse Total Shoulder ◽  
Rotator Cuff Arthropathy

A reverse total shoulder arthroplasty (RTSA) is strongly suggested for patients who suffer from rotator cuff (RTC) arthropathy, where RTC deficiency causes abnormal loading leading to articular cartilage damage. Studies show that 47% of RTSA patients have rotator cuff arthropathy and 27% have some form of osteoarthritis (OA) [1].

Influence of Humeral Version and Deltoid Tension on Glenohumeral Kinematics After Reverse Total Shoulder Arthroplasty

2011 ◽  
Author(s):  
Heath B. Henninger ◽  
Alexej Barg ◽  
Robert Z. Tashjian ◽  
Robert T. Burks ◽  
Kent N. Bachus ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Outcome Measures ◽  
Shoulder Arthroplasty ◽  
Surgical Intervention ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
And Function ◽  
Reverse Total Shoulder

Reverse total shoulder arthroplasty (rTSA) is used to improve pain and function in arthritic, rotator cuff deficient shoulders. Surgical intervention is considered successful if range of motion and stability of the joint is maximized and force to abduct the arm is minimized. Implant hardware positioning may affect these outcome measures.

scholarly journals Reverse Total Shoulder Arthroplasty in the Massive Rotator Cuff Tear

2014 ◽  
Vol 17 (3) ◽  
pp. 145-150 ◽  
Author(s):  
Jin Young Jeong ◽  
Hong Eun Cha
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Rotator Cuff Tears ◽  
Massive Rotator Cuff Tear ◽  
Cuff Tear ◽  
Biceps Tenotomy ◽  
Reverse Total Shoulder

In the patients of retracted massive rotator cuff tears, there are much of difficulty to functional recovery and pain relief. Nevertheless the development of treatment, there are still debates of the best treatments in the massive rotator cuff tears. Recenlty various of treatments are introduced; these are acromioplasty with debridement, biceps tenotomy, great tuberoplasty with biceps tenotomy, partial repair, mini-open rotator cuff repair, arthroscopic rotator cuff repair, soft tissue augmentation, tendon transfer, flap, hemiarthroplasty, and reverse total shoulder arthroplasty. That there is no difference of result for reverse total shoulder arthroplasty between patients who have massive rotator cuff tear without arthritis and patients who have cuff tear arthropathy. Reverse total shoulder arthroplasty is one of reliable and successful treatment options for massive rotator cuff tear. Especially it is more effective for patients who have a pseudoparalysis.

scholarly journals Total Shoulder Arthroplasty versus Reverse Total Shoulder Arthroplasty: Outcome Comparison in Osteoarthritis patients with or without Concurrent Rotator Cuff Deficiency

2021 ◽  
Author(s):  
Zeling Long ◽  
Tony Chieh-Ting Huang ◽  
Hanzhong Yu ◽  
Wanchun Wang ◽  
Yicun Wang
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Structural Damage ◽  
Clinical Decision Making ◽  
Total Shoulder Arthroplasty ◽  
Economic Cost ◽  
Reverse Total Shoulder Arthroplasty ◽  
Complication Rates ◽  
Rotator Cuff Deficiency ◽  
Reverse Total Shoulder

Abstract BackgroundOsteoarthritis (OA) is a common shoulder disorder that impacts shoulder functions. Shoulder arthroplasty is often required to restore function and quality of life. Reverse total shoulder arthroplasty (RSA), which was originally designed mainly for irreparable rotator cuff damage, has gained popularity in recent years for the treatment of advanced shoulder OA instead of the clinically standard total shoulder arthroplasty (TSA). However, this RSA has some nonnegligible flaws such as higher complications rate and economic cost, not mention the following problems caused by irreversible physical structural damage. Therefore, the employment of RSA needs to be carefully considered.PurposeThis study aimed to compare TSA and RSA in OA patients with or without rotator cuff damage to better guide clinical decision making. We believe the radical use of RSA in patients without rotator cuff deficiency may cause more harm than good.Study designCross-sectional studyMethodsWe queried the Nationwide Inpatient Sample (NIS) database from 2011 to 2014 to collect information on OA patients who received TSA and RSA. Patients were divided into 2 groups of comparison according to the presence of rotator cuff deficiency and matched with propensity score analysis.Results A total of 57,156 shoulder arthroplasties were identified. RSA patients in the rotator cuff deficiency group had significant higher transfusion rates and longer hospital stays. RSA patients without rotator cuff deficiency had a statistically significantly higher number of implant-related mechanical complications, acute upper respiratory infections and postoperative pain. Overall, RSA incurred higher costs in both groups.ConclusionFor OA patients with rotator cuff deficiencies, RSA has its benefits as complication rates were comparable to TSA. For those patients without rotator cuff deficiencies, the use of RSA should be reconsidered as there were more complications with higher severity.

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