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Review
. 2023 Jan 31:7:24715492231152733.
doi: 10.1177/24715492231152733. eCollection 2023.

Anatomic Shoulder Arthroplasty in the Setting of Concurrent or Prior Rotator Cuff Repair: A Systematic Review

Zylyftar Gorica  1 , Kimberly McFarland  2 , Conor N O'Neill  1 , Jennifer Vanderbeck  1 , Alexander R Vap  1
Affiliations
Review

Anatomic Shoulder Arthroplasty in the Setting of Concurrent or Prior Rotator Cuff Repair: A Systematic Review

Zylyftar Gorica et al. J Shoulder Elb Arthroplast. .

Abstract

Background: Reverse total shoulder arthroplasty (RSA) is the gold standard in management of osteoarthritis (OA) in the setting of rotator cuff pathology. However, there are significant complications associated with the procedure. An alternative option in the setting of a deficient rotator cuff may be to perform a repair prior to or concurrently with an anatomic total shoulder arthroplasty (aTSA).

Methods: A systematic review was performed utilizing Preferred Reporting Items for Systematic Meta-Analyses (PRISMA) guidelines to evaluate outcomes in aTSA with concomitant or prior rotator cuff repair (RCR). Key outcomes were complication rate and subjective outcome scores.

Results: Seven studies were included in the review. One study found a higher rate of total adverse events in the prior repair group (17% vs 7%, P = .01) while others found no significant difference. There was a nonstatistically significant increase in revision rates among patients with larger tears at time of repair. Prior repair groups were associated with a higher rate of re-tear in one study (13% vs 1%, P = .014). Concomitant repair was associated with a higher rate of loosening. In patients with prior repair, there was no statistical difference in strength, range of motion (ROM), simple shoulder test (SST), Single Assessment Numeric Evaluation (SANE), American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), and visual analogue scale (VAS). In patients with concurrent repair, one study demonstrated a less drastic improvement in Hospital for Special Surgery (HSS) in "moderate" repairs as opposed to "good" repairs.

Conclusions: Anatomic TSA is an appropriate treatment for glenohumeral OA in patients with a prior successful RCR and in younger patients with concurrent repair of small or medium tears.

Level of evidence: Level III.

Keywords: anatomic; concomitant; prior; repair; rotator cuff; shoulder arthroplasty.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Preferred Reporting Items for Systematic Meta-Analyses (PRISMA) schema.
See this image and copyright information in PMC

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