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

Abstract

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.

Keywords

• rotator cuff tear
• shoulder arthropathy
• reverse shoulder arthroplasty