Preoperative Single Assessment Numeric Evaluation Score Predicts Poor Outcomes After Reverse Shoulder Arthroplasty for Massive Rotator Cuff Tears Without Arthritis

Abstract

Limited clinical evidence is available to help to predict poor outcomes after reverse shoulder arthroplasty (RSA) among patients with massive rotator cuff tears without glenohumeral arthritis. A retrospective case-control study was performed for patients who underwent RSA for massive rotator cuff tear without glenohumeral arthritis (Hamada score ≤3) and had a minimum of 2 years of follow-up. Preoperative risk factors for poor outcomes were subsequently analyzed. Sixty patients (mean age, 71.4±7.4 years) met the inclusion criteria. Of these, 18 (30%) patients had poor outcomes (case group). The case group had significantly worse postoperative Single Assessment Numeric Evaluation (SANE) (61.6±29.5 vs 84.9±14.1, respectively; P =.002), American Shoulder and Elbow Surgeons (58.9±22.5 vs 82.2±14.2, respectively; P <.001), and Simple Shoulder Test (5.4±3.6 vs 8.5±2.4, respectively; P =.002) scores compared with the control group. Patients with poor outcomes had significantly higher preoperative SANE scores compared with control subjects (40.4±28.4 vs 18.8±15.7, respectively; P =.021). The results of this study suggest that patients with better overall preoperative function, as represented by higher SANE scores, have a greater likelihood of poor functional outcomes after RSA for massive rotator cuff tears without glenohumeral arthritis. For these patients, alternative treatment options should be considered. [ Orthopedics . 2022;45(4):215–220.]

Massive and Irreparable Rotator Cuff Tears: A Review of Current Definitions and Concepts

“… 25 , 41 For a frame of reference, the 10-year revision rate of RSA has ranged from 12% to 43%, 1 , 52 , 87 and dissatisfaction with RSA is more common for this indication (MIRCT without arthritis) than others. 43 , 46 , 63 Moreover, the nature of revision procedures after RSA is generally more morbid than failed repair. Pain-relieving procedures such as debridement, biceps tenotomy, and subacromial balloon placement have been shown to not provide as much functional improvement as complete or partial repair even when postoperative structural healing was not examined.…”