Reverse Total Shoulder Arthroplasty in Patients with Severe Rotator Cuff-Deficient Shoulder: A Minimum Three-Year Follow-up Study

Kim,  Myung Sun; Yeo,  Je Hyoung

doi:2013.16.2.73

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Original Article

Clinics in Shoulder and Elbow 2013;16(2):73-83.
DOI: https://doi.org/10.5397/CiSE.2013.16.2.73 Published online December 31, 2013.

Reverse Total Shoulder Arthroplasty in Patients with Severe Rotator Cuff-Deficient Shoulder: A Minimum Three-Year Follow-up Study

Myung Sun Kim, Je Hyoung Yeo

Department of Orthopaedic Surgery, Chonnam National University Medical School, Gwangju, Korea. mskim@jnu.ac.kr

심한 회전근 개 부전을 동반한 환자에 대한 역형 견관절 전치환술 - 최소 3년 추시 결과 -

김명선·여제형

전남대학교 의과대학 정형외과학교실

Abstract

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)degrees to 129.1(110~180)degrees. 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.

Key Words: Cuff tear arthropathy; Pseudoparalysis; Rotator cuff deficiency; Reverse total shoulder arthroplasty; Complication

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