Reverse arthroplasty of the shoulder for treating rotator cuff arthropathy

Abstract

Objectiveto present a retrospective analysis on the clinical-functional results and complications among patients with rotator cuff arthropathy (RCA) who underwent reverse arthroplasty of the shoulder.Methodspatients with a diagnosis of RCA associated with pseudoparalysis of anterior elevation who underwent reverse arthroplasty of the shoulder with a minimum follow-up of one year were selected.Resultspreoperative information was gathered from our shoulder and elbow arthroplasty register, comprising age, sex, laterality, history of previous procedures, Constant's functional scores and the preoperative range of motion as described in the protocol of the American Academy of Shoulder and Elbow Surgery (ASES). After a mean follow-up of 44 months, 17 patients (94%) were satisfied with the result from the procedure.Conclusionreverse arthroplasty for treating RCA in patients with pseudoparalysis of the shoulder was shown to be effective in achieving a statistically significant improvement in range of motion regarding anterior flexion and abduction. However, in this series, there was no improvement in range of motion regarding external and internal rotation. Reverse arthroplasty is a procedure that reestablishes shoulder joint function in patients who previously did not present any therapeutic possibilities.

Reverse shoulder arthroplasty: clinical results and quality of life evaluation

“…The results are consistent with other studies that used the same rating scale, showing clinical improvement and final results between 72 and 84 7, 9. The improvement of symptoms was also demonstrated by authors who used other assessment tools 5, 6, 8, 10, 16. A significant improvement was also observed in pain, decreasing from 7.9 to 1 in the VAS, a finding similar to that reported by other authors 7 …”

“…Due to the small sample size, stratified analysis was not performed. Fávaro et al 8 observed a rate of complications of only 4%, a lower incidence than that reported in the present study and by other authors 5, 6, 9, 10, 16. This is possibly explained by the fact that their study only included cases of primary arthroplasty, with a shorter follow-up period than that of the present study.…”

“…Moreover, the minimum follow-up time of 24 months, although meeting the requirements of most orthopedic journals, does not address possible long-term complications possible in arthroplasties procedures. However, the authors emphasize that the mean follow-up time of 53 months was superior to that of the other Brazilian studies 5, 8…”

Clinical and functional evaluation of patients submitted to reverse arthroplasty with minimum one year of follow-up

“…In turn, Muh et al 15 showed an LR improvement of approximately 10°, a preoperative mean of 10° (−20 to 70°) to 19.6° (−10 to 70°) in the postoperative period ( p < 0.05). Amaral et al 16 failed to observe alterations in pre and postoperative LR. 16 This variability is justified because LR depends on several factors, such as the integrity of the lateral rotators (infraspinatus and teres minor tendons), the number of fibers mobilized from the posterior portion of the deltoid muscle, and the type of prosthesis used.…”

“…Amaral et al 16 failed to observe alterations in pre and postoperative LR. 16 This variability is justified because LR depends on several factors, such as the integrity of the lateral rotators (infraspinatus and teres minor tendons), the number of fibers mobilized from the posterior portion of the deltoid muscle, and the type of prosthesis used. 11 , 12 In an attempt to obtain clinical and functional LR improvements, new surgical techniques have been used; transfer of the latissimus dorsi is one of the most common.…”