Simone Cerciello1,2,3, Andrew Paul Monk4, Enrico Visonà5, Stefano Carbone6, Thomas Bradley Edwards7, Nicola Maffulli8,9, Gilles Walch10. 1. Casa di Cura Villa Betania, Via Piccolomini 27, 00165, Rome, Italy. simone.cerciello@me.com. 2. Marrelli Hospital, via Gioacchino da Fiore 0962, Crotone, Italy. simone.cerciello@me.com. 3. , Via R. Zandonai 11, 00135, Rome, Italy. simone.cerciello@me.com. 4. NDORMS, University of Oxford, Oxford, UK. 5. Ospedali Riuniti Padova Sud-ULSS 17, Schiavonia, PD, Italy. 6. Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy. 7. Fondren Orthopaedic Group, Texas Orthopaedic Hospital, Houston, USA. 8. Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, Salerno, Italy. 9. Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK. 10. Centre Orthopédique Santy, Lyon, France.
Abstract
INTRODUCTION: Secondary cuff failure after shoulder replacement is disabling and often requires additional surgery. Increased critical shoulder angle (CSA) has been found in patients with cuff tear compared to normal subjects. The interobserver reliability of the CSA and the relationship between CSA and symptomatic secondary cuff failure after shoulder replacement were investigated. MATERIALS AND METHODS: Nineteen patients with symptomatic cuff failure after anatomic shoulder replacement (mean FU 45 months) were compared to a control group of 29 patients showing no signs of symptomatic cuff failure (mean FU 105.7 months). The CSA was measured by two blinded surgeons at a mean follow-up of 45 and 105.7 months, respectively. Inter-observer reliability was calculated. RESULTS: The mean CSA in the study group in neutral, internal and external rotations were 33°, 34° and 34°, respectively. Corresponding values in the control group were 32°, 32° and 32°. The interclass correlation coefficient for the whole population between the two examiners were 0.956 (P < 0.01), 0.964 (P < 0.01) and 0.955 (P < 0.01), respectively. CONCLUSION: There were no significant differences of CSA values between patients who had undergone shoulder replacement and experienced late cuff failure and those in whom the same procedure had been successful. A good inter-observer reliability was found for the CSA method.
INTRODUCTION: Secondary cuff failure after shoulder replacement is disabling and often requires additional surgery. Increased critical shoulder angle (CSA) has been found in patients with cuff tear compared to normal subjects. The interobserver reliability of the CSA and the relationship between CSA and symptomatic secondary cuff failure after shoulder replacement were investigated. MATERIALS AND METHODS: Nineteen patients with symptomatic cuff failure after anatomic shoulder replacement (mean FU 45 months) were compared to a control group of 29 patients showing no signs of symptomatic cuff failure (mean FU 105.7 months). The CSA was measured by two blinded surgeons at a mean follow-up of 45 and 105.7 months, respectively. Inter-observer reliability was calculated. RESULTS: The mean CSA in the study group in neutral, internal and external rotations were 33°, 34° and 34°, respectively. Corresponding values in the control group were 32°, 32° and 32°. The interclass correlation coefficient for the whole population between the two examiners were 0.956 (P < 0.01), 0.964 (P < 0.01) and 0.955 (P < 0.01), respectively. CONCLUSION: There were no significant differences of CSA values between patients who had undergone shoulder replacement and experienced late cuff failure and those in whom the same procedure had been successful. A good inter-observer reliability was found for the CSA method.