Does having a rotator cuff repair prior to reverse total shoulder arthroplasty influence the outcome?

Erickson, Brandon J.; Ling, Daphne; Wong, Alexandra C.; Eno, Jonathan-James; Dines, Joshua S.; Dines, David M.; Gulotta, Lawrence V.

doi:10.1302/0301-620x.101b1.bjj-2018-0874.r1

Cited by 32 publications

(41 citation statements)

References 18 publications

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“…Patients with a previous RCR have been shown to derive benefit from RTSA [39]. However, there is no consensus on whether a history of RCT is an independent risk factor for inferior RTSA outcomes [39][40][41][42][43].…”

Section: Rtsa For Massive Irreparable Rotator Cuff Tearsmentioning

confidence: 99%

“…However, when looking specifically at a patient's history of undergoing a previous RCR, the evidence has shown conflicting results in short-term follow-up studies. The number of RTSAs performed after a failed RCR has been steadily increasing, but it has yet to be established if a previous RCR to the ipsilateral shoulder leads to inferior outcomes [41,43].…”

Section: Prior Surgerymentioning

confidence: 99%

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Advances and Update on Reverse Total Shoulder Arthroplasty

Thon

Seidl

Bravman

et al. 2019

Curr Rev Musculoskelet Med

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Purpose of Review Reverse total shoulder arthroplasty (RTSA) is a procedure that has been increasingly utilized since its inception over 20 years ago. The purpose of this review is to present the most up to date practice and advances to the RTSA literature from the last 5 years. Recent Findings Recent literature on RTSA has focused on identifying complications, maximizing outcomes, and determining its cost-effectiveness. RTSA has become a valuable tool in the treatment of various shoulder pathologies from fractures to massiveirreparable rotator cuff tears. Maximizing outcomes, proper patient counseling, and limiting complications are vital to a successful procedure. Summary RTSA can be a difficult procedure; however, when utilized appropriately, it can be an invaluable tool in the orthopedic surgeon's armament. Recent evidence suggests, more and more, that RTSA not only provides value to the patient, but it is also cost-effective.Keywords Reverse total shoulder arthroplasty . RTSA . Reverse shoulder . Reverse shoulder arthroplasty . Reverse shoulder prosthesis . Outcomes models: (1) By eliminating the neck, the joint's center of rotation (COR) is in direct contact with the center of the glenosphere, providing a fixed COR and reducing the amount of torque placed on the glenoid component-bone interface; (2) the large-diameter glenosphere improves mobility and stability;(3) medializing the COR recruits more deltoid fibers for elevation and abduction; and (4) distalization of the COR improves the deltoid's moment arm by restoring its length, thereby decreasing the effort necessary for abduction [3][4][5][6][7][8][9]. These modifications allow the deltoid to initiate shoulder abduction in the absence of a functioning supraspinatus [8][9][10].

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Section: Rtsa For Massive Irreparable Rotator Cuff Tearsmentioning

confidence: 99%

Section: Prior Surgerymentioning

confidence: 99%

Advances and Update on Reverse Total Shoulder Arthroplasty

Thon

Seidl

Bravman

et al. 2019

Curr Rev Musculoskelet Med

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“…A growing amount of literature continues to support the use of RTSA to treat patients who have previously undergone RCR with persistent pain and shoulder dysfunction. 13,26 Erickson et al 13 recently reported significant improvements in patientreported outcome measures at 2 years after RTSA in patients who had previously undergone RCR and concluded that a previous RCR does not appear to adversely affect the early outcome after RTSA. Therefore, when faced with a patient who has Medicare and whose RCR has clinically failed, it is likely becoming increasingly common to perform an RTSA compared with a revision RCR and thus important to study as an endpoint when examining RCR outcomes.…”

Section: Discussionmentioning

confidence: 99%

The Relationship of Staged, Bilateral Arthroscopic Primary Rotator Cuff Repair Timing and Postoperative Complications

Cancienne¹,

Denard²,

Garrigues

et al. 2021

Am J Sports Med

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Background: Although previous studies have reported acceptable clinical outcomes after simultaneous, single-stage bilateral and staged bilateral rotator cuff repair (RCR), few studies have been adequately powered to compare postoperative complication rates at various time intervals between procedures. Purpose: To examine the relationship between the timing of bilateral arthroscopic RCR and complications. Study Design: Descriptive epidemiology study. Methods: Patients from the Medicare data set within the PearlDiver database who underwent bilateral RCR between 2005 and 2014 were identified. These patients were then stratified by time between surgeries into cohorts: (1) single stage, (2) <3 months, (3) 3 to 6 months, (4) 6 to 9 months, (5) 9 months to 1 year, and (6) 1 to 2 years. Surgical and medical complications of these cohorts were compared with those of a control cohort of patients who underwent bilateral RCR >2 years apart using a regression analysis. Results: A total of 11,079 patients who underwent bilateral RCR were identified. Patients who underwent single-stage bilateral arthroscopic RCR experienced higher rates of revision RCR (odds ratio [OR], 2.1; P < .0001), reverse total shoulder arthroplasty (RTSA) (OR, 2.47; P < .0001), and postoperative infection (OR, 2.18; P = .007) in addition to higher rates of venous thromboembolism (VTE) (OR, 1.78; P = .031) and emergency department visits (OR, 1.51; P = .002) compared with the control group. Patients who underwent bilateral RCR with a <3-month interval had higher rates of revision surgery (OR, 1.56; P = .003), RTSA (OR, 1.89; P = .002), and lysis of adhesions (OR, 2.31; P < .0001) in addition to increased rates of VTE (OR, 1.92; P = .015) and emergency department visits (OR, 1.62; P < .0001) compared with the control group. There were no differences in any surgical or medical complications when surgeries were staged by ≥3 months compared with controls. Conclusion: Patients with Medicare undergoing single-stage and staged bilateral RCR who had the second repair within 3 months had significantly higher rates of multiple medical and surgical complications compared with patients waiting >2 years between procedures.

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“…Although most patients who have undergone RTSA have had good clinical results, some have had poor outcomes and high rates of complications, reoperations, and revisions [11,12]. These poor outcomes were dependent on several factors including age, gender, previous rotator cuff repair surgery, and preoperative functional scores such as the American Shoulder and Elbow Surgeons (ASES) score [11,[13][14][15][16]. Additionally, surgeons are able to predict patient outcomes of RTSA based on the preoperative stage of the disease [17].…”

Section: Introductionmentioning

confidence: 99%

Reverse total shoulder arthroplasty in massive rotator cuff tears: does the Hamada classification predict clinical outcomes?

Kääb

Kohut

Irlenbusch³

et al. 2021

Arch Orthop Trauma Surg

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Introduction Reverse total shoulder arthroplasty (RTSA) is a widely recognized treatment to reduce pain and improve shoulder function for patients in various disease stages of cuff tear arthropathy (CTA). However, it remains unclear whether outcomes after RTSA depend on the preoperative stage of CTA. Therefore, this study evaluated whether the Hamada classification influences midterm clinical outcomes after RTSA. Materials and methods In this multicenter observational study, patients underwent inverted bearing RTSA for massive rotator cuff tears or CTA. Shoulders were grouped into those with (Hamada grades 4a, 4b, and 5) and those without (Hamada grades 1, 2, and 3) glenohumeral arthritis. Clinical outcomes, including range of motion, Constant score, American Shoulder and Elbow Surgeons score, and visual analog scale for pain and satisfaction, were determined preoperatively and at 24 and > 30 months. All complications were recorded, and survival free from any implant component revision was calculated. Results Overall, 202 patients (211 shoulders) were treated with RTSA at a mean age of 75.8 ± 6.6 years (range 41.9–91.6 years). Of these, 144 patients (151 shoulders) were available for a mean follow-up of 79.9 ± 24.7 months (range 30.2–132.3 months). No significant between-group differences were found for clinical outcomes at 24 and > 30 months (P > 0.05). Furthermore, the Hamada classification did not correlate with clinical outcomes at 24 (P = 0.98) and > 30 months (P = 0.29). Revision-free implant component survival was similar between groups (P = 0.17). Postoperative complications were found in 11 shoulders, of which 10 required revision. Conclusions Inverted bearing RTSA was found to be an effective treatment with similarly good midterm clinical outcomes, similar revision rates, and high implant survival rates in every stage of massive rotator cuff tears. Overall, the preoperative Hamada classification did not influence clinical outcomes or complications after RTSA.

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Does having a rotator cuff repair prior to reverse total shoulder arthroplasty influence the outcome?

Cited by 32 publications

References 18 publications

Advances and Update on Reverse Total Shoulder Arthroplasty

Advances and Update on Reverse Total Shoulder Arthroplasty

The Relationship of Staged, Bilateral Arthroscopic Primary Rotator Cuff Repair Timing and Postoperative Complications

Reverse total shoulder arthroplasty in massive rotator cuff tears: does the Hamada classification predict clinical outcomes?

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