Key result
Reverse total shoulder arthroplasty significantly improved the mean ASES score from 32.9 to 80.2 and reduced VAS pain scores from 7.5 to 1.5 at a minimum three-year follow-up.
Why the study?
Does reverse total shoulder arthroplasty improve pain and function in patients with severe rotator cuff-deficient shoulders?
Observational (n=13)
No
Does reverse total shoulder arthroplasty improve pain and function in patients with severe rotator cuff-deficient shoulders?
Mean Difference: 47.3
Absolute Event Rate: 80.2% vs 32.9%
p-value: p=0.003
Reverse total shoulder arthroplasty is an effective treatment for pain relief and functional improvement in patients with severe rotator cuff deficiency, though it carries risks of significant complications such as delayed deep infection.
May support reverse TSA for cuff-deficient shoulders; hypothesis-generating and should not yet change practice.
Purpose:The goal of this study is to evaluate the minimum three-year follow-up results of reverse total shoulder arthroplasty (RTSA) for glenohumeral (GH) arthritic and pseudoparalytic patients with severe rotator cuff deficiency.Materials and Methods: We evaluated 13 patients (three males and 10 females) who underwent RTSA from July 2007 to July 2010.The average follow-up duration was 54.2 months (range, 37~74 months).Clinical results were evaluated using the Visual Analog Scale (VAS) for pain, active Range of Motion (ROM): active forward flexion (aFF); active external rotation at the side (aERs); active internal rotation to the back (aIRb), American Shoulder and Elbow Surgeons (ASES) score, Korean Shoulder Score (KSS), and intraoperative and postoperative complications.Results: VAS score improved from 7.5(6~10) points to 1.5(0~4), and ROM of active forward elevation improved from 42.7(10~100)。to 129.1(110~180)。 .In addition, ASES score improved from preoperative 32.9 (11.7~46.7)points to 80.2(58.3~95.0)postoperatively, and KSS score improved from 36.8(24~47) points to 78.4 (61~92).Twelve out of 13 cases showed various degrees of scapular notching at the last follow-up.There was one case of intraoperative anterior glenoid fracture and two cases of temporary nerve injury.Revision surgery was performed in two cases for treatment of delayed postoperative deep infection.Conclusion: According to minimum three-year follow-up results, RTSA may be an effective treatment option for glenohumeral (GH) arthritic and pseudoparalytic patients.However, considering the possibility of complications related to delayed deep infection or surgeon's technique, RTSA should be judiciously and carefully indicated by expert surgeons.
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Kim et al. (2013) conducted an observational in Severe rotator cuff-deficient shoulder (n=13). Reverse total shoulder arthroplasty vs. Preoperative baseline was evaluated on American Shoulder and Elbow Surgeons (ASES) score (MD 47.3, p=0.003). Reverse total shoulder arthroplasty significantly improved the mean ASES score from 32.9 to 80.2 and reduced VAS pain scores from 7.5 to 1.5 at a minimum three-year follow-up.
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