Background: To investigate the effectiveness of reverse total shoulder arthroplasty (RTSA) in treating irreparable massive rotator cuff tears (RCTs). Methods: Twenty-nine patients who underwent RTSA for the treatment of irreparable massive RCTs and completed follow-up for at least 1 year were selected. Their mean age was 69.7 years (range, 59-80 years). The mean follow-up was 17.7 months (range, 12-42 months). The shoulder range of motion was measured preoperatively and at final follow-up. The functional result was evaluated using visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeon (ASES) score, and Korean Shoulder Society (KSS) score. Additionally, the shoulders were categorized into two groups depending on prior history of surgery and the clinical outcomes were analyzed between two groups. Results: Mean pain VAS improved, from 6.6±1.2 to 2.7±0.9 (p=0.001), and the mean functional VAS from 35.7±4.2 to 73.3±5.4 (p=0.006). The mean ASES score improved from 37.2±2.8 to 75.0±3.8 (p=0.012). The mean KSS improved from 36.5±7.2 to 75.6±5.4 (p=0.009), the mean forward elevation from 66.3±4.7 to 135.6±8.4 (p=0.0001), and the mean abduction from 45.2±4.2 to 119.0±6.5o (p=0.0001). Internal rotation differed significantly from the first sacral to the third lumbar vertebrae (p=0.036). External rotation did not change significantly (p=0.076). There was also no statistically significant difference between groups (no previous operation versus none). Four complications occurred: one superficial infection, one with anterior dislocation, one acromial fracture, and one clavicle fracture. Conclusions: RTSA provides reliable pain relief and recovery of shoulder function in patients with massive irreparable RCTs in shortterm follow-up. (Clin Shoulder Elbow 2014;17(4):152-158)
Purpose:The purpose of this study was to analyze clinical and radiological results after debridement arthroplasty during primary elbow arthroplasty. Materials and Methods:This study involved 25 primary elbow osteoarthritis cases that were treated by debridement arthroplasty from January 1996 to December 2004 with at least a 2 year follow up (mean: 41.3 months). Mean patient age was 45.5 years. Clinical outcomes were analyzed using preoperative and postoperative ranges of motion, Mayo Elbow Performance Scores (MEPS), and Visual Analogue Scale scores. Radiologic analysis was based on plain radiographs. Results: Average flexion-extension arc improved from 72o ROM preoperatively to 110.5 o postoperatively (p<0.001). Mean MEPS was 89.5 points preoperatively and increased postoperatively (p<0.05). Humeral fenestration size decreased from 27% to 20.5%. Bony spurs of the olecranon and coronoid process recurred in 8 cases. Postoperative LOM was found to be associated with spur recurrence (p<0.05). Conclusion: Debridement arthroplasty may be recommendable for primary elbow osteoarthritis as it reduces pain and improves functional outcomes, including range of motion. Spur recurrence was found to be associated with a reduced range of motion. ,11,12,14,18,21,23) , 은 방사선학
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