INTRODUCTION: Recent biomechanical data suggests that repairing the subscapularis during reverse shoulder arthroplasty (RSA) can increase the force required by the posterior rotator cuff and deltoid to elevate the arm. METHODS: We retrospectively studied patients who underwent primary RSA and had baseline and minimum 2-year postoperative American Shoulder and Elbow Surgeons (ASES) shoulder scores, stratified them according to subscapularis management, then subgrouped them according to lateralization of the glenosphere component. RESULTS: Patients with subscapularis repair and a lateralized glenosphere had significantly less improvement in ASES scores than did those without lateralization (P = 0.016) and patients without subscapularis repair (P = 0.006). Individually, subscapularis management (P = 0.163) and glenosphere lateralization (P = 0.847) had no significant effect on the change in ASES score but in combination did have a significant effect on the change in ASES score (P = 0.002). DISCUSSION: The combination of subscapularis repair and glenosphere implant lateralization in RSA translates to significantly less clinical improvement. CONCLUSIONS: Patients who underwent both subscapularis repair and glenosphere lateralization had significantly less improvement in ASES scores. LEVEL OF EVIDENCE: Level III.
INTRODUCTION: Recent biomechanical data suggests that repairing the subscapularis during reverse shoulder arthroplasty (RSA) can increase the force required by the posterior rotator cuff and deltoid to elevate the arm. METHODS: We retrospectively studied patients who underwent primary RSA and had baseline and minimum 2-year postoperative American Shoulder and Elbow Surgeons (ASES) shoulder scores, stratified them according to subscapularis management, then subgrouped them according to lateralization of the glenosphere component. RESULTS:Patients with subscapularis repair and a lateralized glenosphere had significantly less improvement in ASES scores than did those without lateralization (P = 0.016) and patients without subscapularis repair (P = 0.006). Individually, subscapularis management (P = 0.163) and glenosphere lateralization (P = 0.847) had no significant effect on the change in ASES score but in combination did have a significant effect on the change in ASES score (P = 0.002). DISCUSSION: The combination of subscapularis repair and glenosphere implant lateralization in RSA translates to significantly less clinical improvement. CONCLUSIONS:Patients who underwent both subscapularis repair and glenosphere lateralization had significantly less improvement in ASES scores. LEVEL OF EVIDENCE: Level III.
Authors: David A Kolin; Michael A Moverman; Nicholas R Pagani; Richard N Puzzitiello; Jeremy Dubin; Mariano E Menendez; Andrew Jawa; Jacob M Kirsch Journal: Clin Orthop Relat Res Date: 2022-03-17 Impact factor: 4.755
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Authors: Robert Z Tashjian; Bradley Hillyard; Victoria Childress; Jun Kawakami; Angela P Presson; Chong Zhang; Peter N Chalmers Journal: J Shoulder Elbow Surg Date: 2020-06-09 Impact factor: 3.019