Emre ERGEN, Mehmet ŞAH ŞAKÇI, Hüseyin Utku ÖZDEŞ, Ersen TÜRKMEN, Kadir ERTEM, Ali CANBAY

Reverse shoulder arthroplasty: Short to mid-term clinical and radiological results

Aim: This paper aimed to review the early and midterm radiological and clinical findings of our patients who were treated surgically with reverse shoulder prosthesis via to rotator cuff arthropathy. Materials and Methods: A total of 22 patients (female: 14, male 8), with shoulder arthrosis due to cuff tears were treated with reverse shoulder prosthesis between 2015 and 2018 in our clinic. The mean age of the patients was detected as 69.4 years (65-93 years). The mean clinical follow-up was detected as 11 months (3-36 month). The patients were evaluated with Visual Analog Scale (VAS), Shoulder Constant Score, American Shoulder/Elbow Surgeons Shoulder Score (ASES) scores, preoperatively. In last outpatient visits, patients were evaluated with radiological views and range of motion, Shoulder Constant, VAS and ASES scores. Results: The mean shoulder flexion, extension, and abduction was measured as 101°, 24°, and 97.9° respectively in the last polyclinic controls. The mean shoulder Constant scores were 30.8 preoperatively and 62.1 at follow-up (p=0.001). Preoperatively, the mean score of ASES was 31.6. And it was increased to 65.9 with the last follow-up (p = 0.001). The mean preoperative VAS scores were 7.42, and the mean postoperative mean were 2.8 (p = 0.001). Periprosthetic fracture developed intraoperatively in one patient who also had a dislocation occurred in the 2nd month postoperatively. In another patient, superficial infection occurred at the postoperative 3rd week. One patient died because of cardiac problems postoperatively and another one had a traumatic periprosthetic fracture at 5th month postoperatively. Conclusion: While clinical presentation of patient is an advanced rotator cuff tear arthropathy, the application of reverse shoulder prosthesis is major surgical procedure. Also, with appropriate rehabilitation protocol, significant improvement in pain and function can be achieved.

PDF

___

1. Clement ND, Nie YX, McBirnie JM. Management of degenerative rotator cuff tears: a review and treatment strategy. Sports Med Arthrosc Rehabil Ther Technol. 2012; 4(1): 48.
2. Werner CM, Steinmann PA, Gilbart M, at al. Treatment of painful pseudoparesis due to irreparable rotator cuff dysfunction with the Delta III reverse-ball-and socket total shoulder prosthesis. J Bone Joint Surg Am 2005; 87:1476-86.
3. Ecklund KJ, Lee TQ, Tibone J, Gupta R. Rotator cuff tear arthropaty. J Am Acad Orthop Surg 2007; 15: 340-349
4. França FO, Freitas JMA, Godinho PC, at al. Clinical and functional evaluation of patients submitted to reverse arthroplasty with minimum one year of follow-up. Rev Bras Ortop. 2018; 53(6): 714-720.
5. Eajazi A, Kussman S, LeBedis C, et al. Rotator Cuff Tear Arthropathy: Pathophysiology, Imaging Characteristics, and Treatment Options. AJR Am J Roentgenol. 2015; 205(5): W502- W511.
6. Sevimli R, Karakaplan M, Korkmaz MF, Gormeli G. Resection Arthroplasty in Shoulder Joint Tuberculosis: A Case Presentation. Gavin J Case Rep 2016; 1: 7-9.
7. Leung B, Horodyski M, Struk AM, at al. Functional outcome of hemiarthroplasty compared with reverse total shoulder arthroplasty in the treatment of rotator cuff tear arthropathy. J Shoulder Elbow Surg 2012; 21:319-23.
8. Hecker A, Aguirre J, Eichenberger U, et al. Deltoid muscle contribution to shoulder flexion and abduction strength: an experimental approach. J Shoulder Elbow Surg. 2021; 30(2): e60-e68.
9. Matsen FA 3rd, Boileau P, Walch G, at al. The reverse total shoulder arthroplasty. J Bone Joint Surg Am 2007; 89:660-7.
10. Brolin TJ, Updegrove GF, Horneff JG. Classifications in Brief: Hamada Classification of Massive Rotator Cuff Tears. Clin Orthop Relat Res. 2017; 475(11): 2819-2823.
11. Boileau P, Watkinson D, Hatzidakis AM, at al: The Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J Shoulder Elbow Surg 2006; 15:527-40.
12. Boileau P, Gonzalez JF, Chuinard C, at al. Reverse total shoulder arthroplasty after failed rotator cuff surgery. J Shoulder Elbow Surg 2009; 18(4):600-6.
13. Sirveaux F, Favard L, Oudet D, at al. Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Joint Surg Br. 2004; 86(3): 388-95
14. Walch G, Bacle G, Lädermann A, at al. Do the indications, results, and complications of reverse shoulder arthroplasty change with surgeon’s experience? J Shoulder Elbow Surg 2012; 21:14707.
15. Wall B, Nové-Josserand L, O’Connor DP, at al. Reverse total shoulder arthroplasty: a review of results according to etiology. J Bone Joint Surg Am 2007; 89:1476-85.
16. Mizuno N, Denard PJ, Raiss P, at al. The clinical and radiographical results of reverse total shoulder arthroplasty with eccentric glenosphere. Int Orthop2012; 36:164753.
17. Fávaro RC, Abdulahad M, Filho SM, at al. Rotator cuff arthropathy: what functional results can be expected from reverse arthroplasty?. Rev Bras Ortop. 2015; 50(5): 523-9.
18. Atalar AC, Salduz A, Cil H, at al. Reverse shoulder arthroplasty: radiological and clinical short-term results. Acta Orthop Traumatol Turc. 2014; 48(1): 25-31.