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:To compare the mid-term clinical results of arthroscopic and open repair for large to massive rotator cuff tear. Materials and Methods:We retrospectively reviewed 48 patients who underwent either arthroscopic or open repair for large to massive rotator cuff tear. 28 patients underwent arthroscopic repair and 20 patients had open repair. The clinical outcome for the 2 groups was evaluated using range of motion, Visual Analogue Scale (VAS) for pain and function, American Shoulder and Elbow Society (ASES) score and Korean Shoulder Scoring System (KSS) score. Results: The range of motion, VAS for pain and function and ASES score was improved significantly in both groups at the final follow-up visit compared with preoperative values. However, there were no significant differences between the two groups statistically (p>0.05). There were no significant differences between the two groups statistically at the final follow-up KSS score (p>0.05) either. Conclusion:We could obtain improved mid-term clinical outcomes in both arthroscopic repair and open repair without any statistically significant differences between the two groups.
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