Document Detail


Massive rotator cuff tears without arthropathy: when to consider reverse shoulder arthroplasty.
MedLine Citation:
PMID:  22301229     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Massive rotator cuff tears often present a challenge for the treating orthopaedic surgeon. A multitude of surgical approaches have been described to manage this condition, ranging from biceps tenotomy to complex muscle transfers to reverse shoulder arthroplasty. Among these procedures, reverse shoulder arthroplasty is increasingly advocated to relieve pain and restore function; however, the exact role of this arthroplasty procedure continues to be defined, particularly in patients without any evidence of associated glenohumeral arthritis. In this patient population, the reverse shoulder prosthesis is used primarily to address the instability associated with massive rotator cuff tears, as opposed to the more common application of arthroplasty to manage cartilage disease. Currently accepted indications for reverse shoulder arthroplasty include patients with pseudoparalysis and irreparable rotator cuff tears, with or without anterosuperior escape. Surgeons must be aware of conditions that may clinically mimic pseudoparalysis caused by a rotator cuff tear, such as axillary nerve injury, deltoid dehiscence, or cervical radiculopathy. These conditions produce deltoid insufficiency and are unlikely to benefit from a reverse shoulder arthroplasty. Caution is also warranted when considering this procedure in patients with massive rotator cuff tears in whom active forward elevation greater than 90° is preserved. These patients may achieve little benefit in range of motion and pain relief with a reverse shoulder arthroplasty.
Authors:
Kevin L Harreld; Brian L Puskas; Mark A Frankle
Related Documents :
23486139 - Learning from our international colleagues: a us plastic surgeon's perspective.
24494469 - Evaluation of surgical glove perforation after laparoscopic and open cholecystectomy.
24315379 - Meta-analysis of sublay versus onlay mesh repair in incisional hernia surgery.
22959019 - Bilateral subdural hematoma after inadvertent dural puncture during epidural analgesia.
22903249 - Childhood pneumonectomies: two decades' experience of a referral center.
23232299 - Esophageal perforation caused by a fish bone treated with surgically indwelling drainag...
21394069 - Does bmp increase the incidence of perioperative complications in spinal fusion? a comp...
3588009 - Glottic and tracheal stenosis in spinal cord injured patients.
3038769 - Repeated hepatic resection.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Instructional course lectures     Volume:  61     ISSN:  0065-6895     ISO Abbreviation:  Instr Course Lect     Publication Date:  2012  
Date Detail:
Created Date:  2012-02-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7507149     Medline TA:  Instr Course Lect     Country:  United States    
Other Details:
Languages:  eng     Pagination:  143-56     Citation Subset:  IM    
Affiliation:
Shoulder and Elbow Fellow, Florida Orthopaedic Institute, Tampa, Florida.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  How to minimize complications in shoulder instability and rotator cuff surgery.
Next Document:  Complications of the reverse prosthesis: prevention and treatment.