PURPOSE: The reverse shoulder prost hesis (rTSA) is now implanted by the same percentage of anatomic shoulder prosthesis in the USA. Scapular notching and loss of extrarotation have been underlined as complication at long-term follow-up due to the Grammont design. The current trend to reduce those limits is to position both components lateralized. As the role of the subscapularis tendon in this new rTSA design is unclear, the purpose of this study is to quantify rTSA outcomes in patients with or without subscapularis tendon suture. METHODS: The surgery was performed by the same orthopaedic surgeon (F.F.), using a Aequalis Ascend™ Flex prosthesis (Tornier, Montbonnot, France) with a bone autograft. Forty-four patients underwent surgery with the tendon sutured, whereas 40 patients underwent the same surgery without repairing it. Patients were evaluated pre-operatively and at the last follow-up using Constant score, VAS, and ROM. The minimum and mean follow-ups were six and 16.6 months, respectively. RESULTS: All patients showed statistically significant improvement in pain and joint function following surgery. This study highlighted significant higher values in intrarotation and abduction, respectively, with and without suturing the subscapularis tendon. However, no significant differences were underlined in Constant score, VAS, forward flexion, extrarotation at 0° and 90° of abduction, and rate of instability. CONCLUSIONS: As predicted, significant clinical improvements were observed in both groups with some differences. These clinical results showed that the use of rTSA with lateralized humerus and bony increase offset leads to realistic clinical improvements with a low risk of instability without the need for compression and stabilization of the tendon.
PURPOSE: The reverse shoulder prost hesis (rTSA) is now implanted by the same percentage of anatomic shoulder prosthesis in the USA. Scapular notching and loss of extrarotation have been underlined as complication at long-term follow-up due to the Grammont design. The current trend to reduce those limits is to position both components lateralized. As the role of the subscapularis tendon in this new rTSA design is unclear, the purpose of this study is to quantify rTSA outcomes in patients with or without subscapularis tendon suture. METHODS: The surgery was performed by the same orthopaedic surgeon (F.F.), using a Aequalis Ascend™ Flex prosthesis (Tornier, Montbonnot, France) with a bone autograft. Forty-four patients underwent surgery with the tendon sutured, whereas 40 patients underwent the same surgery without repairing it. Patients were evaluated pre-operatively and at the last follow-up using Constant score, VAS, and ROM. The minimum and mean follow-ups were six and 16.6 months, respectively. RESULTS: All patients showed statistically significant improvement in pain and joint function following surgery. This study highlighted significant higher values in intrarotation and abduction, respectively, with and without suturing the subscapularis tendon. However, no significant differences were underlined in Constant score, VAS, forward flexion, extrarotation at 0° and 90° of abduction, and rate of instability. CONCLUSIONS: As predicted, significant clinical improvements were observed in both groups with some differences. These clinical results showed that the use of rTSA with lateralized humerus and bony increase offset leads to realistic clinical improvements with a low risk of instability without the need for compression and stabilization of the tendon.
Entities:
Keywords:
Cuff tear arthropathy; Reverse total shoulder arthroplasty; Subscapularis tendon
Authors: Christoph Kolling; Mirela Borovac; Laurent Audigé; Andreas M Mueller; Hans-Kaspar Schwyzer Journal: Int Orthop Date: 2017-12-22 Impact factor: 3.075
Authors: T Bradley Edwards; Matthew D Williams; Joanne E Labriola; Hussein A Elkousy; Gary M Gartsman; Daniel P O'Connor Journal: J Shoulder Elbow Surg Date: 2009-03-17 Impact factor: 3.019
Authors: Matthew L Hansen; Aniruddh Nayak; Madusudanan Sathia Narayanan; Kellen Worhacz; Richard Stowell; Marc C Jacofsky; Christopher P Roche Journal: Bull Hosp Jt Dis (2013) Date: 2015-12
Authors: Patric Raiss; Felix Zeifang; Juan Pons-Villanueva; Christopher J Smithers; Markus Loew; Gilles Walch Journal: Int Orthop Date: 2014-04-02 Impact factor: 3.075
Authors: Bryan Wall; Laurent Nové-Josserand; Daniel P O'Connor; T Bradley Edwards; Gilles Walch Journal: J Bone Joint Surg Am Date: 2007-07 Impact factor: 5.284
Authors: M De Fine; M Sartori; G Giavaresi; R De Filippis; G Agrò; S Cialdella; Milena Fini; G Pignatti Journal: Arch Orthop Trauma Surg Date: 2021-02-26 Impact factor: 2.928
Authors: Francesco Ascione; Alfredo Schiavone Panni; Adriano Braile; Katia Corona; Giuseppe Toro; Nicola Capuano; Alfonso M Romano Journal: J Orthop Traumatol Date: 2021-07-08
Authors: Alexander Paszicsnyek; Olivia Jo; Harshi Sandeepa Rupasinghe; David C Ackland; Thomas Treseder; Christopher Pullen; Greg Hoy; Eugene T Ek; Lukas Ernstbrunner Journal: J Clin Med Date: 2022-01-12 Impact factor: 4.241