Rotator cuff arthropathy: what functional results can be expected from reverse arthroplasty?

Abstract

ObjectiveTo evaluate the functional results from reverse arthroplasty and its complications and relationships with types of injury.MethodsTwenty-seven shoulders (26 women and one man) were treated. The patients were assessed using the UCLA functional scale. The implant used was the Delta Xtend Depuy® model. The injuries were classified using the Seebauer method for the degree of arthroplasty and the Nerot method for notching.ResultThe mean age was 77.4 years (range: 67–89) and the follow-up was 25.8 months (range: 6–51). The preoperative UCLA score was 10.1 (range: 6–15) and the postoperative UCLA score was 29.8 (range: 22–35), which was a statistically significant improvement (p < 0.001). According to the Seebauer classification, five patients were 1B, 19 were 2A and three were 2B. Fifteen cases presented complications (55.5%) and notching was the commonest of these, occurring in 14 patients (nine with grade 1 and five with grade 2), but this did not cause instability in any of them. Only one patient (3.7%) had a major complication, consisting of dislocation in the immediate postoperative period. Two patients (7.4%) said that they would undergo the procedure again. One patient (3.7%) underwent a revision procedure.ConclusionReverse arthroplasty was shown to be an excellent option for treating patients with rotator cuff arthropathy, with a low rate of major complications. Notching was a frequent complication, but in the majority of the cases, it did not present clinical repercussions.

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

“…Despite the problems and complications, 100% of the present patients were satisfied and declared that they would undergo a reverse arthroplasty again, a result close to that described by Fávaro et al, 26 in which only one patient declared that he would not undergo the procedure again.…”

“…The incidence of scapular notching in the present sample was 14.3%, similar to that published in the literature based on the prosthesis model used (Equinoxe ® , Exactech Inc.; Gainesville, FL) and with a lower percentage than the Brazilian studies published on this problem. 16 , 18 , 26 As described by Wright, this is the most frequent problem after reverse arthroplasty. 27…”