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KMID : 1036220150180030138
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Clinics in Shoulder and Elbow
2015 Volume.18 No. 3 p.138 ~ p.143
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Effect of Preoperative Fatty Degeneration of the Deltoid and the Teres Minor Muscles on the Clinical Outcome after Reverse Total Shoulder Arthroplasty
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Moon Sung-Hoon
Nam Woo-Dong
Rheu Chang-Hyun
Lee Jae-Woo
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Abstract
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Background: To evaluate the effect of preoperative fatty degeneration of deltoid and teres minor muscles on the clinical outcome in patient with reverse total shoulder arthroplasty (RTSA).
Methods: Nineteen patients with RTSA were enrolled. The mean follow-up period was 16.1 months. The fatty degeneration of three distinct parts in each deltoid and the teres minor muscle was measured using a preoperative magnetic resonance imaging. Postoperatively, the muscle strengths for forward elevation (FE), abduction (Abd), and external rotation (ER) were measured using a myometer at the last follow-up. The parameters for clinical outcome were Constant Score (CS) and Korean Shoulder Score (KSS).
Results: The number of cases was 10 in group 1 and 9 in group 2. The strength of FE and Abd were significantly higher in group 1 (p<0.001 and p<0.001, respectively), and the strength of ER was not different significantly between two groups (p=0.065). For the clinical outcome, both CS and KSS were higher in group 1 (p=0.002 and p=0.002, respectively). The number of patients in group A was 11, and group B was 8. Although there was not a significant difference in terms of FE and Abd between group A and B (p=0.091, p=0.238), ER was significantly higher in group A (p=0.012). We did not find a significant difference in the clinical scores (CS, p=0.177 and KSS, p=0.238).
Conclusions: These findings suggest the importance of a preoperative evaluation of the fatty degeneration of deltoid and teres minor muscles for predicting postoperative strength and clinical outcome.
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KEYWORD
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Massive rotator cuff tear, Cuff tear arthropathy, Reverse total shoulder arthroplasty, Deltoid fatty degeneration, Teres minor fatty degeneration
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