OUTCOMES OF REVERSE ARTHROPLASTY IN PATIENTS WITH SHOULDER ARTHROPATHY AND MASSIVE ROTATOR CUFF TEAR

Purpose— to evaluate mid-term outcomes of reverse joint replacement in patients with shoulder arthropathy and massive rotator cuff tear.Material and Methods. Reverse shoulder arthroplasty with delTa xTeNd (depuy) was performed in 38 patients in the period from december 2010 to december 2016 by the same surgical team. patients’ age ranged from 38 to 82 years. Indications for replacement were pain syndrome and pseudoparalysis of the upper limb in presence of a large or massive Rc tear as well as shoulder arthropathy of various severity degree. Outcomes were evaluated by standard aSeS, cS and ucla scales. Roentgenological examination included ap and axial x-rays during follow up from 1 to 6 years after the surgery with analysis of implants positioning. Mean follow up was 24,2±6,6 months.Results. good outcomes were reported in 6 (15,8%) patients. average functional scores were: aSeS 87,4±2,1, ucla 29,7±1,5 and cS 14,0±2,3. Satisfactory outcomes were observed in 27 (14,2%) patients: aSeS 76,2±2,3, ucla 26,8±1,3 and cS 22,0±1,4 scores. poor outcomes were reported in 5 (14,2%) patients with persisting pain syndrome.Conclusion.To avoid significant and multiple complications after reverse shoulder replacement a precise preoperative planning considering particular destructive changes of glenoid fossa is required. For young and physically active patients the authors recommend to use alternative treatment options aiming at restoration of normal shoulder biomechanics and prophylaxis of arthropathy.

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Comparison of Clinical and Structural Outcomes by Subscapularis Tendon Status in Massive Rotator Cuff Tear

The American Journal of Sports Medicine ◽

10.1177/0363546517721187 ◽

2017 ◽

Vol 45 (11) ◽

pp. 2555-2562 ◽

Cited By ~ 8

Author(s):

Sung Hyun Lee ◽

Dae Jin Nam ◽

Se Jin Kim ◽

Jeong Woo Kim

Keyword(s):

Magnetic Resonance Imaging ◽

Rotator Cuff ◽

Rotator Cuff Tear ◽

Rotator Cuff Tears ◽

Subscapularis Tendon ◽

Resonance Imaging ◽

Massive Rotator Cuff Tear ◽

Cuff Tear ◽

Massive Rotator Cuff Tears

Background: The subscapularis tendon is essential in maintaining normal glenohumeral biomechanics. However, few studies have addressed the outcomes of tears extending to the subscapularis tendon in massive rotator cuff tears. Purpose: To assess the clinical and structural outcomes of arthroscopic repair of massive rotator cuff tears involving the subscapularis. Study Design: Cohort study; Level of evidence, 3. Methods: Between January 2010 and January 2014, 122 consecutive patients with massive rotator cuff tear underwent arthroscopic rotator cuff repair. Overall, 122 patients were enrolled (mean age, 66 years; mean follow-up period, 39.5 months). Patients were categorized into 3 groups based on subscapularis tendon status: intact subscapularis tendon (I group; n = 45), tear involving less than the superior one-third (P group; n = 35), and tear involving more than one-third of the subscapularis tendon (C group; n = 42). All rotator cuff tears were repaired; however, subscapularis tendon tears involving less than the superior one-third in P group were only debrided. Pain visual analog scale, Constant, and American Shoulder and Elbow Surgeons scores and passive range of motion were measured preoperatively and at the final follow-up. Rotator cuff integrity, global fatty degeneration index, and occupation ratio were determined via magnetic resonance imaging preoperatively and 6 months postoperatively. Results: We identified 37 retears (31.1%) based on postoperative magnetic resonance imaging evaluation. Retear rate in patients in the C group (47.6%) was higher than that in the I group (22.9%) or P group (20.0%) ( P = .011). Retear subclassification based on the involved tendons showed that subsequent subscapularis tendon retears were noted in only the C group. The improvement in clinical scores after repair was statistically significant in all groups but not different among the groups. Between-group comparison showed significant differences in preoperative external rotation ( P = .021). However, no statistically significant difference was found in any shoulder range of motion measurements after surgery. Conclusion: Arthroscopic repair of massive tears results in substantial improvements in shoulder function, despite the presence of combined subscapularis tears. However, this study showed a high failure rate of massive posterosuperior rotator cuff tear repair extending more than one-third of the subscapularis tendon. When combined subscapularis tendon tear was less than the superior one-third of the subscapularis tendon, arthroscopic debridement was a reasonable treatment method where comparable clinical and anatomic outcomes could be expected.

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Reverse shoulder arthroplasty for massive rotator cuff tear: risk factors for poor functional improvement

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2015.04.015 ◽

2015 ◽

Vol 24 (11) ◽

pp. 1698-1706 ◽

Cited By ~ 53

Author(s):

Robert U. Hartzler ◽

Brandon M. Steen ◽

Michael M. Hussey ◽

Michael C. Cusick ◽

Benjamin J. Cottrell ◽

...

Keyword(s):

Risk Factors ◽

Rotator Cuff ◽

Rotator Cuff Tear ◽

Shoulder Arthroplasty ◽

Reverse Shoulder Arthroplasty ◽

Functional Improvement ◽

Massive Rotator Cuff Tear ◽

Cuff Tear

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Arthroscopic Partial Repair of Massive Contracted Rotator Cuff Tears

Clinics in Shoulder and Elbow ◽

10.5397/cise.2014.17.1.44 ◽

2014 ◽

Vol 17 (1) ◽

pp. 44-47 ◽

Cited By ~ 1

Author(s):

Sung Jae Kim ◽

Young Hwan Kim ◽

Yong Min Chun

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Functional Outcomes ◽

Muscle Quality ◽

Rotator Cuff Tears ◽

Massive Rotator Cuff Tear ◽

Cuff Tear ◽

Partial Repair ◽

Tendon Coverage

Typically, massive rotator cuff tears have stiff and retracted tendon with poor muscle quality, in such cases orthopaedic surgeons are confronted with big challenging to restore the cuff to its native footprint. Furthermore, even with some restoration of the footprint, it is related with a high re-tear rate due to less tension free repair and less tendon coverage. In this tough circumstance, the partial repair has yielded satisfactory outcomes at relatively short follow-up by re-creating the transverse force couple of the rotator cuff. Through this partial repair, the massive rotator cuff tear can be converted to the "functional rotator cuff tear" and provide improvement in pain and functional outcomes in patient's shoulder.

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EXPERIENCIA CLINICA EN PROTESIS REVERSA DE HOMBRO EN CENTRO MEDICO NAVAL

International Journal of Advanced Research ◽

10.21474/ijar01/13906 ◽

2021 ◽

Vol 9 (12) ◽

pp. 287-290

Author(s):

Jesus Flores Espinosa ◽

Ruperto Alfonso Munoz Galguera

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Therapeutic Option ◽

Reverse Shoulder Arthroplasty ◽

Clinical Results ◽

Shoulder Prosthesis ◽

Massive Rotator Cuff Tear ◽

Simple Shoulder Test ◽

Suitable Alternative ◽

Cuff Tear

Problem Statement: The total reverse arthroplasty of man is a suitable therapeutic option for shoulder osteoarthritis associated with cuff rotator tear, massive rotator cuff tear mainly, medializing the rotation center of the shoulder joint, thus replacing the supraspinatus, recovering degree of freedom of movement of the shoulder with the promising clinical results described in the literature, interest has arisen on the part of the traumatology and orthopedics service to evaluate the clinical evolution of the patients operated with this procedure, and generate the knowledge that can be integrated later in studies of May scientific validity. Objective: Objective: to describe the clinical outcome of patients undergoing surgery, with total reverse shoulder arthroplasty, after 6 months of surgery in a naval medical center. Methodology: Type of study: an observational, cross-sectional, retrospective study was carried out. Population: 8 patients que fueron intervenidos quirÃƒÂºrgicamente con artroplastia total reversa de hombro. The DASH, Constan and Simple Shoulder Test tests were applied, which were applied preoperatively and after 6 months of the surgical intervention, and the description and analysis of data was carried out with a statistical program. Results: there was clinical improvement in most patients on the DASH scale with average disability improvement of 59% to 36%, Constan scale from 25.7 to 49.6, Simple Shoulder Test from 3.1 to 5.6. Conclusion. The total reverse shoulder prosthesis is a suitable alternative with adequate clinical results for patients with rotator cuff tear, massive rotator cuff tear.

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