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Reverse rotator cuff surgery

M Petri, J A Greenspoon, S G Moulton, P J Millett
BACKGROUND: Massive rotator cuff tears in active patients with minimal glenohumeral arthritis remain a particular challenge for the treating surgeon. METHODS: A selective literature search was performed and personal surgical experiences are reported. RESULTS: For patients with irreparable rotator cuff tears, a reverse shoulder arthroplasty or a tendon transfer are often performed. However, both procedures have rather high complication rates and debatable long-term results, particularly in younger patients...
2016: Open Orthopaedics Journal
U Butt, M S Rashid, D Temperley, S Crank, A Birch, A J Freemont, I A Trail
AIMS: The aim of this study was to analyse human muscle tissue before and after rotator cuff repair to look for evidence of regeneration, and to characterise the changes seen in the type of muscle fibre. PATIENTS AND METHODS: Patients were assessed pre-operatively and one year post-operatively using the Oxford Shoulder Score (OSS) and MRI. The cross-sectional area and distribution of the type of muscle fibre were assessed on biopsies, which were taken at surgery and one year post-operatively...
October 2016: Bone & Joint Journal
Raffaele Garofalo, Brody Flanagin, Alessandro Castagna, Vittorio Calvisi, Sumant G Krishnan
BACKGROUND AND PURPOSE: Rupture of the anterior and middle deltoid muscle associated with rotator cuff tear arthropathy (RCA) could result in a definitive loss of shoulder function. The purpose of this study was to evaluate clinical outcomes after a concomitant reverse shoulder arthroplasty (RSA) and deltoid repair under these circumstances. MATERIALS AND METHODS: Between 2006 and 2012, 18 consecutive patients with a mean age of 69.7 years, affected by massive irreparable rotator cuff tear and associated dehiscence or rupture of anterior and middle deltoid muscle underwent this operation through a modified anterosuperior approach...
August 21, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Jeremy S Somerson, Patrick Sander, Kamal Bohsali, Ryan Tibbetts, Charles A Rockwood, Michael A Wirth
BACKGROUND: In selected patients with a desire to maintain activity levels greater than those recommended after reverse total shoulder arthroplasty, hemiarthroplasty remains an option for treatment of cuff tear arthropathy (CTA). However, given the relatively small case series that have been reported to date, little is known regarding which patients will show functional improvement after this surgery. QUESTIONS/PURPOSES: We asked: What factors are associated with achieving the minimum clinically important difference in the simple shoulder test (SST) after hemiarthroplasty for cuff tear arthropathy? PATIENTS AND METHODS: Between 1991 and 2007, two surgeons at one academic center performed 48 shoulder hemiarthroplasties for CTA...
August 16, 2016: Clinical Orthopaedics and related Research
Brian T Samuelsen, Eric R Wagner, Matthew T Houdek, Bassem T Elhassan, Joaquin Sánchez-Sotelo, Robert Cofield, John W Sperling
BACKGROUND: Reverse total shoulder arthroplasty (RTSA) has classically been reserved for patients older than 65 years with rotator cuff arthropathy, pseudoparalysis, and severe pain. This investigation assessed outcomes in a consecutive series of patients aged 65 and younger undergoing primary RTSA. METHODS: There were 63 patients (67 shoulders; 40 women, 27 men) with a mean age of 60 years (range, 50-65 years). Indications were cuff tear arthropathy (CTA) in 51, severe glenohumeral arthritis in 15, and osteonecrosis in 1...
August 10, 2016: Journal of Shoulder and Elbow Surgery
Patric Raiss, T Bradley Edwards, Thomas Bruckner, Markus Loew, Felix Zeifang, Gilles Walch
BACKGROUND: The aim of this multicenter study was to analyze the clinical and radiographic outcome and to report on the types of complications in patients with chronic locked shoulder dislocation treated with reverse shoulder arthroplasty. METHODS: Twenty-two patients with a mean age of 71 years were included. The mean duration of follow-up was 3.5 years. Preoperatively, computed tomography or magnetic resonance imaging scans were performed and analyzed for bone defects and the status of the rotator cuff...
August 10, 2016: Journal of Shoulder and Elbow Surgery
Brian C Werner, Brenda Chang, Joseph T Nguyen, David M Dines, Lawrence V Gulotta
BACKGROUND: The American Shoulder and Elbow Surgeons (ASES) questionnaire was developed to provide a standardized method for evaluating shoulder function. Previous studies have determined the clinical responsiveness of this outcome measure for heterogenous populations or patients with nonoperatively treated rotator cuff disease. Currently, to our knowledge, no studies exist that establish the clinically relevant change in the ASES score after shoulder arthroplasty. QUESTIONS/PURPOSES: We asked: (1) What are the minimal clinically important difference (MCID) and substantial clinical benefit (SCB) for the ASES score after primary and reverse shoulder arthroplasties? (2) Are the MCID and SCB for the ASES score different between primary and reverse shoulder arthroplasties? (3) What patient-related factors are associated with achieving the MCID and SCB after total shoulder arthroplasty and reverse shoulder arthroplasty? METHODS: A longitudinally maintained institutional shoulder arthroplasty registry was retrospectively queried for patients who underwent primary shoulder arthroplasty, including anatomic or reverse total shoulder arthroplasty from 2007 to 2013, with a minimum 2-year followup...
July 8, 2016: Clinical Orthopaedics and related Research
K Theivendran, M Varghese, R Large, M Bateman, M Morgan, A Tambe, M Espag, T Cresswell, D I Clark
AIM: We present the medium-term clinical results of a reverse total shoulder arthroplasty with a trabecular metal glenoid base plate. PATIENTS AND METHODS: We reviewed 125 consecutive primary reverse total shoulder arthroplasties (RTSA) implanted in 124 patients for rotator cuff arthropathy. There were 100 women and 24 men in the study group with a mean age of 76 years (58 to 89). The mean follow-up was 32 months (24 to 60). No patient was lost to follow-up. RESULTS: There were statistically significant improvements in the mean range of movement and Oxford Shoulder Score (p < 0...
July 2016: Bone & Joint Journal
Clay Riley, John Idoine, Yousef Shishani, Reuben Gobezie, Bradley Edwards
Reverse total shoulder arthroplasty (TSA) is a useful intervention for older patients with glenohumeral arthritis and a deficient rotator cuff. However, as a semiconstrained prosthesis, conventional reverse TSA implanted in a young patient could fail over time secondary to polyethylene wear and subsequent osteolysis. A metal-on-metal prosthesis may avoid this type of failure. The purpose of this study is to assess the outcomes in an initial cohort of young patients who underwent reverse TSA using a metal-on-metal prosthesis...
September 1, 2016: Orthopedics
Brent J Morris, Richard E Haigler, John M Cochran, Mitzi S Laughlin, Hussein A Elkousy, Gary M Gartsman, T Bradley Edwards
The potential adverse effect of body mass index (BMI) on shoulder function scores after reverse shoulder arthroplasty (RSA) has not been investigated. We conducted a study to examine outcomes of RSA performed for rotator cuff tear arthropathy (RCTA) across BMI categories (normal weight, overweight, obese). We hypothesized that, compared with normal-weight patients, obese patients would have worse shoulder function scores, worse mobility, and more complications. Using a prospective shoulder arthroplasty registry, we identified 77 primary RSAs performed for RCTA with minimum 2-year follow-up...
May 2016: American Journal of Orthopedics
Brandon J Erickson, Joshua D Harris, Anthony A Romeo
Reverse total shoulder arthroplasty (RTSA) is a treatment option for patients with rotator cuff tear arthropathy, pseudoparalysis, and a functional deltoid. Our hypothesis was that no significant difference in postoperative active range of motion (ROM) will be observed in patients with 135° and 155° humeral cup inclination. A systematic review was registered with PROSPERO and performed with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies evaluating RTSA that reported the type of prosthesis as well as active postoperative ROM were eligible for inclusion...
May 2016: American Journal of Orthopedics
Keiichiro Nishida
The number of cases with rheumatoid arthritis who requires arthroscopic synovectomy is declining, but it is still a useful procedure in combination with effective pharmacologic disease control. For the destruction of glenohumeral joint, total shoulder arthroplasty is effective for pain relief and functional outcome for patients without rotator cuff impairment. The reverse shoulder arthroplasty has been shown favorable short-term results, but need a careful indication for rheumatoid shoulder with poor bone stock and bone quality...
June 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
Robert L Parisien, Paul H Yi, Laura Hou, Xinning Li, Andrew Jawa
BACKGROUND: This study compared the incidence and pattern of potential nerve injuries between reverse shoulder (RSA) and total shoulder arthroplasty (TSA) using intraoperative neuromonitoring. Our hypothesis was that RSA has a greater risk of nerve injury than TSA due to arm lengthening. METHODS: We reviewed 36 consecutive patients who underwent RSA (n = 12) or TSA (n = 24) with intraoperative neuromonitoring. The number of nerve alerts was recorded for each stage of surgery...
July 2016: Journal of Shoulder and Elbow Surgery
Eric C Makhni, Eric Swart, Michael E Steinhaus, Richard C Mather, William N Levine, Bernard R Bach, Anthony A Romeo, Nikhil N Verma
PURPOSE: To compare the cost-effectiveness within the United States health care system of arthroscopic rotator cuff repair versus reverse total shoulder arthroplasty in patients with symptomatic large and massive rotator cuff tears without cuff-tear arthropathy. METHODS: An expected-value decision analysis was constructed comparing the costs and outcomes of patients undergoing arthroscopic rotator cuff repair and reverse total shoulder arthroplasty for large and massive rotator cuff tears (and excluding cases of cuff-tear arthropathy)...
September 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Brian C Werner, Alexandra C Wong, Gregory T Mahony, Edward V Craig, David M Dines, Russell F Warren, Lawrence V Gulotta
BACKGROUND: Although reverse total shoulder arthroplasty (RTSA) has been successful in improving pain and function in most patients, some patients fail to improve clinically. The present study used a large registry of RTSA patients to evaluate associations between patient-related factors and poor postoperative improvement after RTSA. MATERIALS AND METHODS: A prospectively collected shoulder arthroplasty registry was queried for consecutive patients who underwent RTSA from 2007 to 2013...
August 2016: Journal of Shoulder and Elbow Surgery
Adrien J P Schwitzguébel, Céline Haas, Alexandre Lädermann
Shoulder pain is a common problem for general practitioners. The objectives of a shoulder arthroplasty are to improve the articular function and to provide pain relief. Anatomic shoulder arthroplasty is not the treatment of choice if a rotator cuff deficiency is associated with arthritis. In some circumstances (muscle or tendon deficiency) rotator cuff repair is technically impossible. Reverse shoulder arthroplasty (RSA) has opened new opportunities for patients suffering with shoulder conditions such as shoulder pseudoparalysis and revision surgery...
February 3, 2016: Revue Médicale Suisse
Ofer Levy, Ali Narvani, Nir Hous, Ruben Abraham, Jai Relwani, Riten Pradhan, Juan Bruguera, Giuseppe Sforza, Ehud Atoun
BACKGROUND: Reverse shoulder prostheses are increasingly used in recent years for treatment of glenohumeral arthropathy with deficient rotator cuff. Bone preservation is becoming a major goal in shoulder replacement surgery. Metaphyseal humeral components without a stem were developed to minimize bone resection and preserve bone. This study evaluated the clinical and radiologic outcomes at 2 to 7 years using a novel short metaphyseal reverse total shoulder arthroplasty (rTSA) prosthesis without a diaphyseal stem...
August 2016: Journal of Shoulder and Elbow Surgery
Yong Bok Park, Ho Young Ryu, Jin Ho Hong, Young Hoo Ko, Jae Chul Yoo
BACKGROUND: To date, there are few reports of the definite reversibility of rotator cuff muscle atrophy after repair. PURPOSE: To evaluate the reversibility of rotator cuff muscle atrophy after successful arthroscopic repair. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Included in this study were 47 patients (mean age, 61.2 ± 7.3 years; range, 49-73 years) who underwent arthroscopic rotator cuff repair as well as magnetic resonance imaging (MRI) preoperatively and at 6-month and last follow-up...
April 2016: American Journal of Sports Medicine
Joseph N Liu, Grant H Garcia, Gregory Mahony, Hao-Hua Wu, David M Dines, Russell F Warren, Lawrence V Gulotta
BACKGROUND: Traditionally, fewer postoperative sport restrictions are imposed on hemiarthroplasty (HHA) patients on than reverse total shoulder arthroplasty (RTSA) patients. However, functional outcomes have been shown to be superior in RTSA. No direct comparison of RTSA vs HHA has been done on rates of return to sports in patients with glenohumeral arthritis and rotator cuff dysfunction, proximal humeral fractures, or rheumatoid arthritis. METHODS: This is a retrospective review of consecutive RTSA and HHA patients collected from our institution's shoulder arthroplasty registry...
June 2016: Journal of Shoulder and Elbow Surgery
Raffaele Russo, Giuseppe Della Rotonda, Michele Ciccarelli, Fabio Cautiero
PURPOSE: the aim of this study was to analyze complications of reverse total shoulder arthroplasty (RTSA) used to treat different shoulder diseases. METHODS: from March 2000 to March 2013, 195 RTSA were implanted by the senior Author. The indications for reverse prosthesis surgery were secondary osteoarthritis (OA) in 49 cases, irreparable rotator cuff tear (RCT) in 48 cases, and complex humeral fractures in 75 cases, while 19 were patients requiring surgical revision for first prosthesis implant...
April 2015: Joints
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