Early clinical outcomes of reverse shoulder arthroplasty for irreparable rotator cuff tear
10.3760/cma.j.cn121113-20240122-00050
- VernacularTitle:反式肩关节置换治疗不可修复性肩袖撕裂的早期疗效
- Author:
Yi LU
1
;
Shangzhe LI
;
Guang YANG
;
Renjie CHEN
;
Chunyan JIANG
Author Information
1. 首都医科大学附属北京积水潭医院运动医学科，国家骨科医学中心，北京 100035
- Keywords:
Arthroplasty, replacement, shoulder;
Rotator cuff injuries;
Treatment outcome
- From:
Chinese Journal of Orthopaedics
2024;44(14):920-928
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the early curative effect of reverse shoulder arthroplasty in treatment of irreparable rotator cuff tear.Methods:Twenty-three patients with irreparable rotator cuff tears treated with reverse shoulder arthroplasty at Beijing Jishuitan Hospital from January 2020 to December 2022 were retrospectively analyzed, including 4 males and 19 females; age 69.3±8.6 years (range, 51-89 years), of which 8 patients were over 70 years and 15 patients were under 70 years; 5 patients were on the left side and 18 patients were on the right side; the duration of symptoms was 24 (4, 36) months; 7 patients with rotator cuff arthritis (CTA) and 16 with non-CTA. Functional scores including the American Shoulder and Elbow Surgeons (ASES), University of California Los Angeles (UCLA), simple shoulder test (SST), Constant - Murley scores, visual analogue scale (VAS) of pain, and range of motion including forward elevation, external rotation and internal rotation were collected to evaluate the postoperative efficacy of the treatment. ASES was considered as primary outcome, which was greater than 11.6 as for the minimal clinically important difference (MCID). The stratified analysis according to CTA or not and age greater than 70 years or not were performed to compare the efficacy of the two groups respectively.Results:Twenty-three patients were included with a follow-up time of 14.9±2.2 months (range, 12-19 months). The ASES, UCLA and Constant-Murley score improved from 46.6±14.8, 15.4±5.3 and 51.1±18.7 preoperatively to 87.3±4.5, 28.3±2.2 and 78.1±7.6 at the final follow-up, SST improved from 2(1, 4) preoperatively to 9(8, 10) at the final follow-up, VAS score decreased from 4(3, 5) preoperatively to 0(0, 1) at the final follow-up, and forward flexion supination improved from 77.1°±35.8° preoperatively to 125.2°±19.5° at follow-up; the difference between pre- and post-operative for all of the above metrics was statistically significant ( P<0.05). External rotation improved from 29.5°±22.2° preoperatively to 35.0°±13.5° at the final follow-up, and internal rotation improved from 5.0±3.0 points preoperatively to 5.3±2.8 points at the final follow-up, but none of the differences were statistically significant ( P>0.05). Minimal clinical important difference (100%) in postoperative improvement was achieved in all patients. CTA and non-CTA patients, although there was a significant difference between the two groups in preoperative ASES, Constant-Murley, SST, and VAS scores, the differences in each index were not statistically significant postoperatively ( P>0.05); the differences in all indexes between the two age groups, preoperatively and postoperatively, were not statistically significant ( P>0.05). Conclusion:Reverse total shoulder arthroplasty can achieve satisfactory clinical results in the early postoperative period in patients with irreparable rotator cuff tears. Although there are some preoperative functional differences, significant improvement can be achieved with reverse total shoulder arthroplasty regardless CTA or non-CTA patients. There was no significant difference in early postoperative outcomes between patients over 70 years and relatively younger patients.
