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KMID : 0858320130160020073
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Journal of the Korean Shoulder Elbow Society
2013 Volume.16 No. 2 p.73 ~ p.83
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Reverse Total Shoulder Arthroplasty in Patients with Severe Rotator Cuff-Deficient Shoulder - A Minimum Three-Year Follow-up Study -
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Kim Myung-Sun
Yeo Je-Hyoung
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Abstract
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Purpose: The goal of this study is to evaluate the minimum three-year follow-up results of reverse total shoulder
arthroplasty (RTSA) for glenohumeral (GH) arthritic and pseudoparalytic patients with severe rotator cuff deficiency.
Materials and Methods: We evaluated 13 patients (three males and 10 females) who underwent RTSA from July
2007 to July 2010. The average follow-up duration was 54.2 months (range, 37~74 months). Clinical results were
evaluated using the Visual Analog Scale (VAS) for pain, active Range of Motion (ROM): active forward flexion
(aFF); active external rotation at the side (aERs); active internal rotation to the back (aIRb), American Shoulder and
Elbow Surgeons (ASES) score, Korean Shoulder Score (KSS), and intraoperative and postoperative complications.
Results: VAS score improved from 7.5(6~10) points to 1.5(0~4), and ROM of active forward elevation
improved from 42.7(10~100)。to 129.1(110~180)。. In addition, ASES score improved from preoperative 32.9
(11.7~46.7) points to 80.2(58.3~95.0) postoperatively, and KSS score improved from 36.8(24~47) points to 78.4
(61~92). Twelve out of 13 cases showed various degrees of scapular notching at the last follow-up. There was
one case of intraoperative anterior glenoid fracture and two cases of temporary nerve injury. Revision surgery
was performed in two cases for treatment of delayed postoperative deep infection.
Conclusion: According to minimum three-year follow-up results, RTSA may be an effective treatment option for glenohumeral (GH) arthritic and pseudoparalytic patients. However, considering the possibility of complications related to
delayed deep infection or surgeon’s technique, RTSA should be judiciously and carefully indicated by expert surgeons.
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KEYWORD
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Cuff tear arthropathy, Pseudoparalysis, Rotator cuff deficiency, Reverse total shoulder arthroplasty, Complication
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