Is there a relationship between preoperative diagnosis and clinical outcomes in reverse shoulder arthroplasty? An experience in 699 shoulders

Lindbloom, Benjamin J.; Christmas, Kaitlyn N.; Downes, Katheryne; Simon, Péter; McLendon, Paul B.; Hess, Alfred V.; Mighell, Mark A.; Frankle, Mark A.

doi:10.1016/j.jse.2019.04.007

Cited by 62 publications

(36 citation statements)

References 19 publications

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“…Multiple prior studies have similarly demonstrated excellent outcomes and low reoperation rates using a Grammont-style implant. 2,11,21,35 In addition, although our study demonstrated an overall medialization and distalization of the COR and tilt into inferior inclination, we found substantial variation in these factors, with 55 variation in inclination change, 66-mm variation in medialization change, and 51-mm variation in distalization change. A prior study demonstrated similar variation.…”

Section: Association Between Outcomes and Radiographic Implant Positioncontrasting

confidence: 56%

“…Within our study, patient factors were associated with patient-reported functional outcome after RTSA but implant position was not. Prior studies have demonstrated sex 20,35 and age to be a predictor of patient-reported outcomes after RTSA. 20,26 A prior study demonstrated male sex to be associated with complications after RTSA, 44 partially because Cutibacterium acnes is more common in males.…”

Section: Association Between Demographics and Outcomementioning

confidence: 99%

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Outcomes after a Grammont-style reverse total shoulder arthroplasty?

Tashjian

Hillyard

Childress

et al. 2021

Journal of Shoulder and Elbow Surgery

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Background: The purpose of this study was to determine the factors associated with outcomes after reverse total shoulder arthroplasty (RTSA). Methods: We retrospectively evaluated all RTSAs performed by the senior author between January 1, 2007, and November 1, 2017. We evaluated pain visual analog scale (VAS), Simple Shoulder Test (SST), and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) scores and complication and reoperation rates at a minimum of 2-year follow-up. We evaluated preoperative and 2-week postoperative radiographs for glenoid inclination (GI), medialization as distance between the center of the humeral head or glenosphere and the line of the deltoid, and distalization via the acromial-greater tuberosity distance. We performed inter-and intrarater reliabilities via intraclass correlation coefficients (ICCs) and conducted a multivariable analysis. Results: We included 230 RTSAs in the analysis, with 70% follow-up at a median of 3.4 years. Reliability was acceptable with all ICCs >.678. Increased postoperative GI was significantly associated with increased VAS pain postoperatively (P ¼ .008). Increased distalization was associated with an increased rate of complications and reoperations (P ¼ .032). Younger age (P ¼ .008), female gender (P ¼ .009), and lower body mass index (BMI) (P ¼.006) were associated with worse ASES scores. Female gender (P <.001) and lower BMI (P ¼.039) were associated with worse SST scores. Female gender (P ¼ .013) and lower BMI (P ¼ .005) were associated with worse VAS-pain scores. Conclusion: Age, gender, and BMI are associated with outcome after RTSA. In this retrospective analysis of a Grammont-style RTSA, superior inclination is associated with increased pain postoperatively, whereas excessive arm lengthening is associated with increased risk for complication or reoperation.

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Section: Association Between Outcomes and Radiographic Implant Positioncontrasting

confidence: 56%

Section: Association Between Demographics and Outcomementioning

confidence: 99%

Outcomes after a Grammont-style reverse total shoulder arthroplasty?

Tashjian

Hillyard

Childress

et al. 2021

Journal of Shoulder and Elbow Surgery

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“…The largest study included in this review found worse satisfaction rates in men undergoing RTSA for MIRCT without arthritis, and more predictable results in RTSA for CTA. 33 However, most studies found a high complication rate with RTSA, and did not find underlying diagnosis to affect this.…”

Section: Discussionmentioning

confidence: 96%

Reverse total shoulder arthroplasty for irreparable rotator cuff tears without arthritis: A systematic review

Viswanath

Bale

Trail

2021

Journal of Clinical Orthopaedics and Trauma

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Introduction: Indications for reverse total shoulder arthroplasty (RTSA) have expanded over recent years. Whilst cuff tear arthropathy is an accepted indication, the results of its use in those without arthritis is not clear. The aim of this article is to review the literature on RTSA for massive rotator cuff tears without associated arthritis. Methods: A systematic review search was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to find all studies with clinical outcomes on RTSA performed for massive irreparable rotator cuff tears (MIRCT) without arthritis. Results: Of the 160 studies produced by the search, a detailed analysis found 11 articles to be included in this review. There was variability in the implant style used and the outcome measures utilised, but all studies found improvement in the outcome following RTSA. Many studies advised judicious use following high complication rates, and caution was advised in those patients with pre-operatively preserved active forward elevation. Conclusion:The available evidence suggests that RTSA is a reliable option in older patients with persistent pain and lack of function following MIRCT even without arthritis. However, as outcomes are not significantly worse following failed rotator cuff repair, joint preserving options in the younger age group should be carefully considered in light of the relatively high complication rate associated with RTSA.

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“…Comparable outcomes between CTA and ICTs after RTSA were reported despite the subtle effects of demographic factors, such as age and sex. 35 However, Lindbloom et al 28 indicated that male patients with massive rotator cuff tears without osteoarthritis had lower satisfaction levels than patients with CTA after RTSA. Factors including age, sex, smoking, and BMI are known to be related to the magnitude of clinical improvement after RTSA.…”

Section: Discussionmentioning

confidence: 99%

“…However, the use of a single lateralized prosthesis makes it possible to compare the results with other designs of prosthesis and to minimize bias due to differences in prostheses. 28 , 32 Additionally, we tried to overcome these weaknesses through PS matching. Second, this study was conducted as a retrospective study that did not control for various factors.…”

Section: Discussionmentioning

confidence: 99%

Clinical comparison of humeral-lateralization reverse total shoulder arthroplasty between patients with irreparable rotator cuff tear and patients with cuff tear arthropathy

Lee¹,

Chun²,

Kim³

et al. 2020

JSES International

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Background This study aimed to compare the clinical and radiologic outcomes between patients with irreparable cuff tears (ICTs) and those with cuff tear arthropathy (CTA) after reverse total shoulder arthroplasty (RTSA) with a humeral-lateralization prosthesis. Methods A total of 127 patients with ICTs and CTA who underwent RTSA were enrolled and matched at a 1:2 ratio by propensity score. Preoperative shoulder function was assessed for all patients. Radiologic parameters including the acromion–deltoid tuberosity (ADT) distance, lateral humeral offset, and scapular notching were evaluated. Results Thirty-four patients in the ICT group and 68 patients in the CTA group were matched for comparison. Preoperatively, mean active forward flexion in the ICT group (89.7° ± 29.4°) was significantly better than that in the CTA group (65.5° ± 24.0°, P < .001). In the CTA group, fatty infiltration of the supraspinatus was worse (3.7 ± 0.5) and the ADT distance was shorter (134.0 ± 12.0 mm) compared with the ICT group preoperatively (3.3 ± 0.8 [ P = .008] and 140.7 ± 12.5 mm [ P = .001], respectively). There was no significant difference in postoperative functional or radiologic outcomes between the 2 groups. However, gains in active forward flexion (37.9° in ICT group vs. 61.5° in CTA group, P < .01) and abduction (42.1° in ICT group vs. 60.6° in CTA group, P < .01) were significantly greater in the CTA group than in the ICT group. Conclusions Shoulder function was significantly improved after RTSA regardless of the preoperative diagnosis. Postoperatively, radiologic findings were not significantly different between the 2 groups. Due to the fact that preoperative range of motion and rotator cuff status were better in patients with ICTs, improvements in active forward flexion and abduction were significantly greater in patients with CTA.

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Is there a relationship between preoperative diagnosis and clinical outcomes in reverse shoulder arthroplasty? An experience in 699 shoulders

Cited by 62 publications

References 19 publications

Outcomes after a Grammont-style reverse total shoulder arthroplasty?

Outcomes after a Grammont-style reverse total shoulder arthroplasty?

Reverse total shoulder arthroplasty for irreparable rotator cuff tears without arthritis: A systematic review

Clinical comparison of humeral-lateralization reverse total shoulder arthroplasty between patients with irreparable rotator cuff tear and patients with cuff tear arthropathy

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