Results of Surgical Treatment of Denerative Arthropathy of the Rotator Cuff Using Hemiarthroplasty- Cta®

Abstract

Objective: To assess results of CTA® partial shoulder arthroplasty for treatment of degenerative arthropathy of the rotator cuff. Methods: Between December 2006 and June 2009, 23 shoulders of 23 patients were submitted to CTA® type partial shoulder arthroplasty for treatment of arthropathy secondary to rotator cuff injury. Post-operative follow up time ranged from 6 to 35 months. Mean age was 74.1 years. Patients were predominantly female, representing 78.3% of cases. The right limb was affected in 18 patients. All patients had undergone at least 6 months of physiotherapy without improvement of the algetic picture, and being submitted to surgery by the same surgical team. None of the patients had history of surgery on the affected shoulder. The method elected for assessing patients during post-operative follow up was based on UCLA scoring criteria. Results: Improvement in pain was observed in all patients after arthroplasty. Mean UCLA pain score was 9.22 (ranging from 10 to 8). Mean function was 6 (10 to 2). Active frontal flexion was 2.39 (highest score 4 and lowest 0). Mean frontal flexion force was 4.09, maximum was 5 and minimum 3. Mean score on the UCLA was 26.52. 95% were satisfied with the surgery. Conclusion: CTA® type partial shoulder arthroplasty produced satisfactory results in the treatment of degenerative arthropathy of the rotator cuff and had a low rate of complications.

Low-term results from non-conventional partial arthroplasty for treating rotator cuff arthroplasthy

“…During a mean follow-up of 1.6 years, there were improvements in the clinical parameters and UCLA score, as described in the paper by Brasil Filho et al 14 These patients were evaluated prospectively in the present study after a mean follow-up of 5.4 years.…”

“…Additional examinations, such as computed tomography and magnetic resonance imaging, are not necessary for diagnosing arthropathy of the rotator cuff, but they help in making preoperative assessments to analyze the bone stock and the conditions of the rotator cuff, such as fatty degeneration 12, 13, 14…”

Use of cuff tear arthroplasty head prosthesis for rotator cuff arthropathy treatment in elderly patients with comorbidities

“…Additionally, it needs an intact functioning motor, such as the deltoid muscle and the axillary nerve. (1) Among 16 patients submitted to hemiarthroplasty for treatment of arthropathy due to lesion of the rotator cuff, Field et al (9) found that four out of six patients with unsatisfactory results had been submitted to previous acromioplasty, with release of the coracoacromial ligament.…”

“…The term “degenerative arthropathy of the rotator cuff” was first described by Neer, in 1983, and means the collapse of the glenohumeral joint secondary to a massive chronic lesion of the rotator cuff, causing insufficiency of the rotator cuff, rising (cranialization) of the humeral head, joint destruction, synovial fluid alterations, subchondral cysts, flattening of the greater tubercle, osteophytes, acetabularization of the coracoacromial arch, and osteopenia; (1-4) the first three changes were present in all patients. (5) …”

“…It is a partial prosthesis with a larger humeral head in order to provide greater contact with the coracoacromial arch, allowing improvement of the lever arm of the deltoid muscle in arm elevation movement. (1,6,8) …”