Document Detail

Reverse total shoulder arthroplasty improves function in cuff tear arthropathy.
MedLine Citation:
PMID:  21116759     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Early failure due to glenoid loosening with anatomic total shoulder arthroplasty in patients with severe rotator cuff deficiency led to the development of the reverse ball-and-socket shoulder prosthesis. The literature reports improved short-term pain and function scores following modern reverse total shoulder arthroplasty (RTSA) in patients with cuff tear arthropathy (CTA).
QUESTIONS/PURPOSES: We therefore sought to confirm previously reported short-term improvements in pain, function scores, and range of motion, in patients treated with RTSA for CTA and to identify clinical complications and radiographic notching.
METHODS: We retrospectively reviewed 67 patients who underwent 71 primary RTSAs for CTA. The average age was 74 years (range, 54-92 years). All were preoperatively and postoperatively assessed using Constant-Murley and American Shoulder and Elbow Society (ASES) scores. We identified complications and examined radiographs for notching. The minimum followup was 12 months (average, 24 months; range, 12-58 months).
RESULTS: Average Constant-Murley scores improved from 28 preoperatively to 62 postoperatively. Average ASES scores improved from 26 to 76. Subjective Shoulder Value (SSV) improved from 23 to 77. Active forward flexion improved from 61° preoperatively (range, 0°-137°) to 121° postoperatively (range, 52°-170°). Active external rotation was not affected. Thirty-five of the 71 shoulders (49%) showed radiographic notching. The overall complication rate was 23%. No patient required reoperation. One patient required closed reduction of a perioperative dislocation.
CONCLUSIONS: RTSA for CTA results in functional improvement, with a low complication rate. However, the longevity of the device is currently unknown.
LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Betsy M Nolan; Elizabeth Ankerson; J Michael Wiater
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-02     Completed Date:  2011-09-30     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2476-82     Citation Subset:  AIM; IM    
Indiana University School of Medicine, Indiana University, 541 Clinical Drive, Suite 600, Indianapolis, IN 46202, USA.
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MeSH Terms
Aged, 80 and over
Arthroplasty, Replacement* / adverse effects,  instrumentation
Disability Evaluation
Joint Prosthesis
Middle Aged
Muscle Strength
Pain Measurement
Pain, Postoperative / etiology,  prevention & control
Prosthesis Design
Range of Motion, Articular
Recovery of Function
Retrospective Studies
Rotator Cuff / injuries,  physiopathology,  radiography,  surgery*
Shoulder Joint / physiopathology,  radiography,  surgery*
Shoulder Pain / etiology,  prevention & control
Tendon Injuries / physiopathology,  radiography,  surgery*
Time Factors
Treatment Outcome

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

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