Minimum 2-Year Clinical Outcomes After Superior Capsule Reconstruction Compared with Reverse Total Shoulder Arthroplasty for the Treatment of Irreparable Posterosuperior Rotator Cuff Tears in Patients Younger Than 70 Years Old

2020 ◽  
Author(s):  
L Lacheta ◽  
M Horan ◽  
B Goldenberg ◽  
G Dornan ◽  
PJ Millett
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Rotator Cuff Tears ◽  
Superior Capsule Reconstruction ◽  
Reverse Total Shoulder

scholarly journals Reverse total shoulder arthroplasty in massive rotator cuff tears: does the Hamada classification predict clinical outcomes?

2021 ◽  
Author(s):  
Max J. Kääb ◽  
Georges Kohut ◽  
Ulrich Irlenbusch ◽  
Thierry Joudet ◽  
Falk Reuther
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Shoulder Arthroplasty ◽  
Constant Score ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Rotator Cuff Tears ◽  
Multicenter Observational Study ◽  
Massive Rotator Cuff Tears ◽  
Reverse Total Shoulder

Abstract Introduction Reverse total shoulder arthroplasty (RTSA) is a widely recognized treatment to reduce pain and improve shoulder function for patients in various disease stages of cuff tear arthropathy (CTA). However, it remains unclear whether outcomes after RTSA depend on the preoperative stage of CTA. Therefore, this study evaluated whether the Hamada classification influences midterm clinical outcomes after RTSA. Materials and methods In this multicenter observational study, patients underwent inverted bearing RTSA for massive rotator cuff tears or CTA. Shoulders were grouped into those with (Hamada grades 4a, 4b, and 5) and those without (Hamada grades 1, 2, and 3) glenohumeral arthritis. Clinical outcomes, including range of motion, Constant score, American Shoulder and Elbow Surgeons score, and visual analog scale for pain and satisfaction, were determined preoperatively and at 24 and > 30 months. All complications were recorded, and survival free from any implant component revision was calculated. Results Overall, 202 patients (211 shoulders) were treated with RTSA at a mean age of 75.8 ± 6.6 years (range 41.9–91.6 years). Of these, 144 patients (151 shoulders) were available for a mean follow-up of 79.9 ± 24.7 months (range 30.2–132.3 months). No significant between-group differences were found for clinical outcomes at 24 and > 30 months (P > 0.05). Furthermore, the Hamada classification did not correlate with clinical outcomes at 24 (P = 0.98) and > 30 months (P = 0.29). Revision-free implant component survival was similar between groups (P = 0.17). Postoperative complications were found in 11 shoulders, of which 10 required revision. Conclusions Inverted bearing RTSA was found to be an effective treatment with similarly good midterm clinical outcomes, similar revision rates, and high implant survival rates in every stage of massive rotator cuff tears. Overall, the preoperative Hamada classification did not influence clinical outcomes or complications after RTSA.

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 Irreparable Rotator Cuff Tears Without Arthritis Treated With Reverse Total Shoulder Arthroplasty

2016 ◽  
Vol 10 (1) ◽  
pp. 296-308 ◽  
Author(s):  
Mandeep S. Virk ◽  
Gregory P. Nicholson ◽  
Anthony A. Romeo
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Treatment Options ◽  
Young Patients ◽  
Reverse Total Shoulder Arthroplasty ◽  
Rotator Cuff Tears ◽  
Patient Comfort ◽  
Dramatic Improvement ◽  
Reverse Total Shoulder

Background: Irreparable rotator cuff (RC) tears without arthritis is a challenging clinical problem in young adults. Reverse total shoulder arthroplasty (RTSA) has been proposed as one of the surgical treatment options for this condition. Methods: In this review, we discuss the current understanding of the role of RTSA for the management of irreparable RC tears without arthritis based on authors personal experience and available scientific literature. Results: Reverse total shoulder arthroplasty (RTSA) is a constrained arthroplasty system that can allow the deltoid and remaining rotator cuff to substitute for the lost function of irreparable RC. Furthermore, the pain relief is consistent with often a dramatic improvement in patient comfort, shoulder function and stability. In patients with pseudoparalysis of the shoulder without advanced arthritis, RTSA effectively restores forward elevation above the shoulder but may not dramatically improve external (ER) or internal rotation (IR). However, due to concerns over implant longevity, caution has to be exercised when using RTSA for symptomatic irreparable RC tears with preserved active forward elevation (AFE) and in patients less than 65 years of age. Conclusion: RTSA is a reasonable surgical option for irreparable rotator cuff repair without arthritis. However, caution should be exercised when offering RTSA to young patients and patient without pseudoparalysis because they can have a higher complication and dissatisfaction rate. In addition, longevity of RTSA and subsequent need for revision surgery remains a significant concern in this population.

scholarly journals A “Floating Glenoid” after a Reverse Total Shoulder Arthroplasty: A Case Report with Literature Review

2021 ◽  
pp. 1-7
Author(s):  
Simon N Bell ◽  
Simon N Bell ◽  
Maxim U.S.I. Christmas ◽  
Jennifer A. Coghlan
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Deltoid Muscle ◽  
Reverse Total Shoulder Arthroplasty ◽  
Rotator Cuff Tears ◽  
Surgical Removal ◽  
Joint Movement ◽  
Complex Proximal Humeral Fractures ◽  
Reverse Total Shoulder

A shoulder replacement for cuff tear arthropathy was the original indication of the reverse total shoulder arthroplasty (rTSA). However, over time, this particular concept of shoulder arthroplasty has found new indications for other pathologies such as complex proximal humeral fractures and irreparable rotator cuff tears with rotator cuff arthropathy. Retensioning of the deltoid muscle is a vital step during this procedure in order to restore active elevation however, this can be potentially problematic since it results in anatomical changes and often times increases the stress forces across the acromion. We experienced a rare case of an 84-year-old female presenting with an extensive fracture resulting in a “floating glenoid” after reverse total shoulder arthroplasty via a deltopectoral approach. In our case, the patient presented with gradual onset pain in the posterior shoulder with point tenderness over the acromion, which worsened during active joint movement. The patient was definitively managed with surgical removal of the glenoid implants and conversion to a hemiarthroplasty. While there are existing strategies for preventing fractures of this nature, further research is still necessary to establish best management guidelines of these fracture complications associated with rTSA in order to achieve optimal outcomes.

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