Reverse shoulder arthroplasty in 41 patients with cuff tear arthropathy with a mean follow-up period of 5 years

Abstract

Background: Reverse shoulder arthroplasty (RSA) is an accepted treatment for patients with pseudoparalysis due to cuff tear arthropathy. There have been limited studies with midterm clinical and radiologic results. We present our results for a single surgeon from a district general hospital.

Methods: Forty-one consecutive Delta III RSAs were performed by an anterosuperior approach in 37 patients (29 women and 8 men) with pseudoparalysis due to cuff tear arthropathy. The patients' mean age was 79 years (range, 68-91 years). The mean follow-up period was 5 years. All patients were available for final review, and none were lost to follow-up.

Results: The mean age-adjusted Constant and Oxford scores improved from 34.2 points to 71.0 points and 15 points to 33 points, respectively. Mean abduction and forward flexion improved from 64° to 100° and 55° to 110°, respectively. Scapular notching was seen in 68% of patients, but there was no deterioration in function or satisfaction scores. Stress shielding of the proximal humerus was seen in 10% of patients. One patient underwent revision to a hemiarthroplasty because of glenoid component failure after a fall. There were no early postoperative dislocations in our series.

Conclusion: RSA for pseudoparalysis due to cuff tear arthropathy provides good functional results at 5 years; however, there is a high rate of scapular notching, which does not seem to affect overall functional outcomes.

Keywords: Delta; Reverse shoulder arthroplasty; cuff tear arthropathy.